DR. ERIC LARSSON (NPI# 1447338702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447338702 |
| Entity Type | Individual |
| Full Name | DR. ERIC LARSSON |
| Credential | P.H.D, L.P. |
| Practice Address |
2925 Dean Pkwy Suite 300 Minneapolis MN 55416-4470 |
| Practice Telephone | 6129258365 |
| Practice Fax Number | 6129258366 |
| Mailing Telephone | 6129258365 |
| Mailing Fax Number | 6129258366 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2016-04-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
LP1531 | MN | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
LP1531 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BCBS OF MN | 0638K3LA | 01 |
| MN | 688548900 | 05 |
| Street Address |
2925 DEAN PKWY SUITE 300 |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55416-4470 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407494099 | Doreen P. Poehling | Behavior Technician | 2925 Dean Pkwy, Minneapolis, MN 55416-4470 | 2019-12-15 |
| 1598200073 | Gail H Quinn | Behavioral Analyst | 2925 Dean Pkwy, Suite 300, Minneapolis, MN 55416-4470 | 2016-12-20 |
| 1649728940 | Shawn Paul Kinsella | Behavioral Analyst | 2925 Dean Pkwy, Suite 300, Minneapolis, MN 55416-4470 | 2016-09-14 |
| 1972051274 | Thomas Currier | Behavioral Analyst | 2925 Dean Pkwy, 300, Minneapolis, MN 55416-4470 | 2016-09-14 |
| 1487732764 | Lovaas Institute for Early Intervention - Midwest, Inc. | Behavioral Analyst | 2925 Dean Pkwy, Suite 300, Minneapolis, MN 55416-4470 | 2006-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1598307860 | Ayman Abulaziz Mohamed | Counselor | 4326 Park Glen Rd, St Louis Park, MN 55416 | 2019-10-08 |
| 1831758929 | Ally Group Homes LLC | Assisted Living Facility | 2944 Princeton Ave South, Saint Louis Park, MN 55416 | 2019-06-11 |
| 1609371525 | Heather Margaret Flatgard | Chiropractor | 5407 Excelsior Blvd Ste D, St Louis Park, MN 55416 | 2018-03-25 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1316469760 | Evert Ray Boyd | Psychologist | 3200 Highway 100 S., Groves Academy, St Louis Park, MN 55416 | 2017-07-07 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1326410416 | Clear Health Chiropractic LLC | Chiropractor | 5614 W 36th St, St. Louis Park, MN 55416 | 2015-10-28 |
| 1568897833 | Kay Elizabeth Lichtenberger | Physical Therapist | 4415 W 36.5 St, St. Louis Park, MN 55416 | 2013-09-05 |
| 1710221510 | Aaron Christopher Oppelt | Counselor | 1665 Utica Ave South - Suite 100, Saint Louis Park, MN 55416 | 2012-11-16 |
| Find all providers in zip 55416 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801208566 | Rose Mary Boerboom | Psychologist | 415 N 1st St, #502, Minneapolis, MN 55401-4305 | 2014-05-28 |
| 1073826913 | Scott Michael Jacoby | Psychologist | 2110 Lyndale Ave S, Minneapolis, MN 55405-3196 | 2010-07-20 |
| 1174686216 | Susan A Medo | Psychologist | 100 W Franklin Ave, Minneapolis, MN 55404-2433 | 2006-12-19 |
| 1417035551 | Jennifer Lynn Joseph | Psychologist | 3001 Broadway St Ne, Suite 185, Minneapolis, MN 55413-2195 | 2006-11-02 |
| 1942380316 | Janice L Ostrom | Psychologist | 4535 Washburn Ave N, Minneapolis, MN 55412-1055 | 2006-10-17 |
| 1740376268 | Debra Ann Stack | Psychologist | 2124 Dupont Avenue South #104, Minneapolis, MN 55403 | 2006-10-04 |
| 1194093641 | Kavita Mahesh Desai | Psychologist | 2545 Chicago Ave S, Suite 306, Mail Stop 17-306, Minneapolis, MN 55404-4543 | 2011-12-12 |
| 1649411406 | Meredith L. Gunlicks-stoessel | Psychologist | 2450 Riverside Ave, F256/2b West, Department of Psychiatry, Minneapolis, MN 55454-1450 | 2009-03-09 |
| 1114083540 | Brih Design LLC | Psychologist | 4535 Washburn Ave N, Minneapolis, MN 55412-1055 | 2006-12-29 |
| 1003987983 | Murray Joseph Mcallister | Psychologist | 800 E 28th St, Minneapolis, MN 55407-3723 | 2006-11-13 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55416 |
Please comment or provide details below to improve the information on DR. ERIC LARSSON.
| 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.