Lara Irene Kroodsma, MA,MS, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1189 Issued in NH

Practice address

250 Commercial St
Suite 3004
Manchester, NH 03101-1142

Phone

(603) 848-3387

Fax

(603) 668-8666

NPI assigned

Feb 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Master of Science

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254096000000",
    "number": "1972642809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 COMMERCIAL ST",
            "address_2": "SUITE 3004",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011142",
            "telephone_number": "603-848-3387",
            "fax_number": "603-668-8666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 COMMERCIAL ST",
            "address_2": "SUITE 3004",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011142",
            "telephone_number": "603-848-3387",
            "fax_number": "603-668-8666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROODSMA",
        "first_name": "LARA",
        "middle_name": "IRENE",
        "name_prefix": "Dr.",
        "credential": "MA,MS, PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2009-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "1189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "7706646Y0NH01",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Marie Kraunelis, RN, BC, LICSW
• Catlyn Kraus
• Kathryn Ryan Krippendorf, AS
• Eric Joseph Krochmal
• Judi Ann Krolik, RN
• Sushmita Krovi, LCMHC
• Emily Krueger, BS
• Kendra Krueger
• Larissa D Krug
• Alexandra Krupp

• Clinical Psychologist in Manchester, NH
• Providers in Manchester, NH by specialty
• Clinical Psychologist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2009; 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.