Active NPI
Kelly Larkin
- Counselor
- Ellisville, MO
National Provider Identifier
1861844698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 2016019115
- Practice address
- 811 Corvallis CT.
Ellisville, MO 63021-4767 - Phone
- (314) 941-0875
- NPI assigned
- Jul 5, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 2016019115 | MO | Primary |
Addresses
Primary practice location
811 Corvallis CT.
Ellisville, MO 63021-4767
Mailing address
811 Corvallis CT
Ellisville, MO 63021-4767
Phone (314) 941-0875
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016019115 | MO | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467676800000",
"number": "1861844698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "811 CORVALLIS CT",
"city": "ELLISVILLE",
"state": "MO",
"postal_code": "630214767",
"telephone_number": "314-941-0875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 CORVALLIS CT.",
"city": "ELLISVILLE",
"state": "MO",
"postal_code": "630214767",
"telephone_number": "314-941-0875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARKIN",
"first_name": "KELLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-05",
"last_updated": "2016-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MO",
"license": "2016019115",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellisville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.