KELLY LARSEN (NPI# 1073851093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073851093 |
| Entity Type | Individual |
| Full Name | KELLY LARSEN |
| Practice Address |
6302 Thirteenth Avenue Lucerne CA 95458 |
| Mailing Address |
Po Box 1024 Lucerne CA 95458-1024 |
| Practice Telephone | 7072749101 |
| Practice Fax Number | 7072749192 |
| Mailing Telephone | 7072749101 |
| Mailing Fax Number | 7072749192 |
| Enumeration Date | 2013-01-25 |
| Last Update Date | 2013-01-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730495169 | Kelly Jean Larsen | Occupational Therapy Assistant | 12460 Birch Dr, Brookfield, WI 53005-3862 | 2010-08-23 |
| 1942756804 | Kelly C Larsen | Psychologist | 500 Laser Rd Ne, Rio Rancho, NM 87124-4517 | 2016-08-31 |
| 1497024152 | Kelly J Larsen | Counselor | 111 N County Farm Rd, Wheaton, IL 60187-3977 | 2011-12-23 |
| 1831134600 | Kelly Kristine Larsen | Optometrist | 720 Birchwood Ave, Bellingham, WA 98225-1714 | 2006-06-17 |
| Street Address |
6302 THIRTEENTH AVENUE |
| City | LUCERNE |
| State | CA |
| Zip Code | 95458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093871592 | Robyn Carrie Rosin | Counselor | 6302 Thirteenth Avenue, Lucerne, CA 95458 | 2006-12-29 |
| 1740743293 | Holly Heather Austinson | Counselor | 6302 Thirteenth Avenue, Lucerne, CA 95458 | 2019-04-11 |
| 1245682392 | Teresa Lynn Wilson | Counselor | 6302 Thirteenth Avenue, Lucerne, CA 95458 | 2016-07-12 |
| 1649513607 | Linda Marie Aldridge | Counselor | 6302 Thirteenth Avenue, Lucerne, CA 95458 | 2013-03-28 |
| 1942551239 | Lesley Robyn Lewis | Registered Nurse | 6302 Thirteenth Avenue, Lucerne, CA 95458-1024 | 2012-09-26 |
| 1346545969 | Christina Marie Drukala | Marriage & Family Therapist | 6302 Thirteenth Avenue, Lucerne, CA 95458 | 2011-01-12 |
| 1598934028 | Paul William Hofacker | Psychologist | 6302 Thirteenth Avenue, Lake County Behavioral Health, Lucerne, CA 95458 | 2008-02-28 |
| 1649490111 | Sheila Elaine Roseneau | Counselor | 6302 Thirteenth Avenue, Lucerne, CA 95458-1024 | 2007-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619527512 | Shawna Dee Theodorou | Case Manager/Care Coordinator | 6302 Thirteeth Ave, Lucerne, CA 95458 | 2019-09-13 |
| 1093274508 | Adventist Health Clearlake Hospital, Inc | Clinic/Center | 6300 E. Highway 20, Lucerne, CA 95458 | 2019-03-14 |
| 1750848396 | Catherine Denise Miller | Case Manager/Care Coordinator | 6302 13 Th Ave, Lucerne, CA 95458 | 2019-03-01 |
| 1043774193 | Priest Martinez | Counselor | 6300 E Hwy 20 Unit B, Lucerne, CA 95458 | 2019-01-23 |
| 1700308962 | Joao Adeles Barta | Case Manager/Care Coordinator | 6302 Thirteenth Av., Lucerne, CA 95458 | 2017-07-10 |
| 1154872737 | Deborah Annette Schmidt | Licensed Vocational Nurse | 6302 13th Ave., Lucerne, CA 95458 | 2016-10-19 |
| 1922496199 | Pearlina Drummond | Counselor | 3937 Foothill Drive, Lucerne, CA 95458 | 2014-12-22 |
| 1467881672 | Lucerne Elementary | Local Education Agency (LEA) | 3351 Country Club Drive, Lucerne, CA 95458 | 2013-11-07 |
| 1003245960 | Hilltop Recovery Services | Substance Abuse Rehabilitation Facility | 3937 Foothill Dr, Lucerne, CA 95458 | 2013-11-01 |
| 1053618652 | Chris Partida | Counselor | 6302 13th Ave, Lucerne, CA 95458 | 2011-02-16 |
| Find all providers in zip 95458 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376804435 | Jeanette Nicole Laird | Counselor | 6302 Thirteenth Ave., Lucerne, CA 95458-1024 | 2012-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972104628 | Ann Egan | Counselor | 207 Cole St, San Francisco, CA 94117-1915 | 2020-11-07 |
| 1821698887 | Ka Yin Emma Liu | Counselor | 1936 University Avenue, Partnerships for Trauma Recover, Suite 191, Berkeley, CA 94704 | 2020-10-29 |
| 1184224693 | Enrique L Hinojosa | Counselor | 817 S Fairmont Ave, Lodi, CA 95240-5116 | 2020-10-26 |
| 1760081376 | Annel Vianey Orduno | Counselor | 3517 Camino Del Rio South Suite 407, San Diego, CA 92108-4026 | 2020-10-23 |
| 1114526407 | David Arthur Lee | Counselor | 1819 Idaho Ave, Santa Monica, CA 90403-3301 | 2020-10-19 |
| 1235737271 | Jeannie Dulberg | Counselor | 540 Wagnon Rd, Sebastopol, CA 95472-9204 | 2020-10-12 |
| 1952909210 | Christopher Shirey | Counselor | 1618 Alhambra Blvd, Sacramento, CA 95816-7601 | 2020-10-09 |
| 1467059105 | Paul Benjamin Mannes | Counselor | 59922 La Brisa Dr, Yucca Valley, CA 92284-9351 | 2020-10-06 |
| 1689271454 | Skycare Cuidado Del Cielo LLC | Counselor | 7890 E Spring St Unit 10d, Long Beach, CA 90815-1622 | 2020-10-05 |
| 1396342135 | Lima Karim | Counselor | 4109 Broadmoor Cmn Apt 207, Fremont, CA 94538-7013 | 2020-10-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.