Robert Dylan Larsen, MA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

93048 Issued in TX

Practice address

106 Austin Ave Ste 207
Weatherford, TX 76086-3381

Phone

(817) 304-5572

NPI assigned

Oct 16, 2023

Last updated

Oct 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1861274706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 SIDEWINDER TRL",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760871311",
            "telephone_number": "181-730-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 AUSTIN AVE STE 207",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760863381",
            "telephone_number": "817-304-5572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Austin Ave Ste 207",
            "address_purpose": "LOCATION",
            "city": "Weatherford",
            "state": "TX",
            "postal_code": "760863381",
            "country_code": "US",
            "telephone_number": "817-304-5572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "ROBERT",
        "middle_name": "DYLAN",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "93048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerilynn Landgraf, LPC
• Brittany Lane
• Sara Lange, PHARMD
• Stephen Gregory Lanier, O.D.
• Katelyn Lara
• Blaire Marie Larson
• Carly Latham, M.S. CCC-SLP
• Tiffany Nichole Latta, LPC
• Candice Lawler, IHP, MBCE
• Kaylee Coleman Lawrence, SLP

• Professional Counselor in Weatherford, TX
• Providers in Weatherford, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.