Active NPI
Bryan K Larison, M.S., L.P.C
- Professional Counselor
- Ponca City, OK
National Provider Identifier
1912024944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2545
- Practice address
- 1500 N 6TH St
Ponca City, OK 74601-2827 - Phone
- (580) 762-7561
- NPI assigned
- Mar 23, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2545 | OK | Primary |
Addresses
Primary practice location
1500 N 6TH St
Ponca City, OK 74601-2827
Mailing address
1401 E Cedar CT
Stillwater, OK 74075-7941
Phone (405) 372-1167
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2545 | OK | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912024944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 E CEDAR CT",
"city": "STILLWATER",
"state": "OK",
"postal_code": "740757941",
"telephone_number": "405-372-1167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 N 6TH ST",
"city": "PONCA CITY",
"state": "OK",
"postal_code": "746012827",
"telephone_number": "580-762-7561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARISON",
"first_name": "BRYAN",
"middle_name": "K",
"name_prefix": "Mr.",
"credential": "M.S., L.P.C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "2545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponca City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.