JENNIFER REBEKAH LARSON (NPI# 1487665584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487665584 |
| Entity Type | Individual |
| Full Name | JENNIFER REBEKAH LARSON |
| Other Name | JENNIFER REBEKAH HIEMENZ |
| Credential | PHD |
| Practice Address |
8406 Six Forks Rd Ste 101 Raleigh NC 27615-3075 |
| Practice Telephone | 9194736451 |
| Practice Fax Number | 8445844207 |
| Mailing Telephone | 9194736451 |
| Mailing Fax Number | 8445844207 |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2019-10-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 2648 | NC | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
2648 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS | 045GA | 01 |
| NC | 6000216 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912512856 | Jennifer Larson | Nurse Practitioner | 8325 Barrens Rd, Roanoke, VA 24019-6701 | 2020-09-08 |
| 1427572189 | Jennifer S Larson | Social Worker | 4703 Nw 53rd Ave Ste B2, Gainesville, FL 32653-3403 | 2017-08-03 |
| 1972975019 | Jennifer Larson | Pharmacist | 2707 Gallop Dr, Santa Rosa, CA 95407-4541 | 2015-10-28 |
| 1962820027 | Jennifer Ciske Larson | Ophthalmology | 2349 Deming Way Deming Way Eye Clinic, Middleton, WI 53562 | 2014-04-04 |
| 1952610412 | Jennifer L Larson | Physical Therapist | 1309 W Guadalupe Rd, Suite 1, Mesa, AZ 85202-9112 | 2010-10-01 |
| 1477866762 | Jennifer Rae Larson | Pharmacist | 702 Eagle Hts, Apt. C, Madison, WI 53705-1587 | 2010-07-15 |
| 1508041807 | Jennifer Larson | Counselor | 25 E Washington St Ste 1406, Chicago, IL 60602-1820 | 2008-01-04 |
| 1902005903 | Jennifer Anne Larson | Dentist | 1110 Se 8th St Bldg 200, Ocala, FL 34471-4045 | 2007-07-11 |
| 1629156500 | Jennifer Sue Larson | Dentist | 216 N Lake St, Boyne City, MI 49712-1210 | 2006-11-01 |
| 1184675233 | Jennifer Larson | Obstetrics & Gynecology | 3624 Brooks St Ste 101, Missoula, MT 59801-7338 | 2006-05-13 |
| Street Address |
8406 SIX FORKS RD STE 101 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27615-3075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588278535 | Emily Grace Johnson | Behavior Technician | 119 Wind Chime Court, Suite 4, Raleigh, NC 27615 | 2020-09-06 |
| 1730706110 | Maja V Martin, Dds, Pa1 | Clinic/Center | 7371 Six Forks Road, Raleigh, NC 27615 | 2020-07-01 |
| 1972146967 | Atlantic Avenue Pharmaceutical, Inc | Pharmacy | 5621 Atlantic Ave, Suite 103, Raleigh, NC 27615 | 2019-10-22 |
| 1023503950 | Siyara Shannay Dobbs | Social Worker | 7013 Woodbend Dr Apt H, Raleigh, NC 27615 | 2018-06-23 |
| 1194210153 | Brittanie Ja'nell Harris | Dentist | 1911 Falls Valley Dr Ste 107, Raleigh, NC 27615 | 2018-06-22 |
| 1710489448 | Sherise Swensen | Social Worker | 8368 Six Forks Road, Suite 101, Raleigh, NC 27615 | 2018-03-08 |
| 1881100345 | Casey Paul Baine | Counselor | 6330 Falls of Neuse Rd Ste 104, Raleigh, NC 27615 | 2017-12-20 |
| 1588177885 | Michael Lacidonia | Acupuncturist | 6400 Falls of Neuse Rd Ste 200, Raleigh, NC 27615 | 2017-11-08 |
| 1457877631 | Matt Henderson | Behavioral Analyst | 8374 Six Forks Road, Suite 101, Raleigh, NC 27615 | 2017-08-18 |
| 1760907646 | Shakeda Muldrow | Social Worker | 7323 Brookbank Lane, Raleigh, NC 27615 | 2017-08-11 |
| Find all providers in zip 27615 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134226384 | Meredith Ann Hickory | Clinical Neuropsychologist | Wakemed Rehabilitation, 3000 New Bern Ave, Raleigh, NC 27610 | 2006-09-20 |
| 1528555604 | Selena Scott | Clinical Neuropsychologist | 3000 New Bern Avenue, Raleigh, NC 27610-1295 | 2018-04-15 |
| 1487180394 | Rochelle O'neil | Clinical Neuropsychologist | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2017-05-11 |
| 1316322076 | Lynn Kakos | Clinical Neuropsychologist | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2015-07-23 |
| 1447635396 | Courtney Brown | Clinical Neuropsychologist | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2015-07-21 |
| 1962813691 | Paul Cohen | Clinical Neuropsychologist | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2014-05-15 |
| 1659688059 | North Carolina Neuropsychiatry | Clinical Neuropsychologist | 13251 Falls of Neuse Rd Ste 121, Raleigh, NC 27614 | 2010-09-07 |
| 1699910182 | Sharon Lynn Leuenberger | Clinical Neuropsychologist | 8520 Six Forks Rd, Suite 204, Raleigh, NC 27615-3095 | 2008-12-11 |
| 1578714846 | Bret A Booth | Clinical Neuropsychologist | 1540 Sunday Dr, Suite 200, Raleigh, NC 27607-6000 | 2008-10-06 |
| 1518158757 | The Neuropsychology Consultants, Pa | Clinical Neuropsychologist | 3824 Barrett Dr, Suite 101, Raleigh, NC 27609-7220 | 2007-08-05 |
| Find all providers in RALEIGH | ||||
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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.