Active NPI
Stephanie Karin Larson
- Clinical Social Worker
- St Cloud, MN
National Provider Identifier
1871919175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 22591
- Practice address
- 4801 Veterans Drive
St. Cloud VA Health Care System
St Cloud, MN 56303 - Phone
- (320) 252-1670
- NPI assigned
- Mar 11, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 22591 | MN | Primary |
Addresses
Primary practice location
4801 Veterans Drive
St. Cloud VA Health Care System
St Cloud, MN 56303
Mailing address
823 9TH Ave N Patio Home 8
Sartell, MN 56377
Phone (320) 247-3978
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 |
|---|---|---|---|
| 22591 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394496000000",
"number": "1871919175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "823 9TH AVE N PATIO HOME 8",
"city": "SARTELL",
"state": "MN",
"postal_code": "56377",
"telephone_number": "320-247-3978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 VETERANS DRIVE",
"address_2": "ST. CLOUD VA HEALTH CARE SYSTEM",
"city": "ST CLOUD",
"state": "MN",
"postal_code": "56303",
"telephone_number": "320-252-1670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "STEPHANIE",
"middle_name": "KARIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-11",
"last_updated": "2014-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "22591",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.