THERESA M. LARSON (NPI# 1881794535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881794535 |
| Entity Type | Individual |
| Full Name | THERESA M. LARSON |
| Credential | LPC |
| Practice Address |
10004 Kennerly Rd Suite 362b Saint Louis MO 63128-2141 |
| Mailing Address |
6310 N Lakeshore Dr House Springs MO 63051-1122 |
| Practice Telephone | 3148490450 |
| Practice Fax Number | 3148490159 |
| Mailing Telephone | 3148054261 |
| Mailing Fax Number | 3148490159 |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
002139 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 498662501 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144569625 | Theresa Larson | Physical Therapist | 3027 Olive St, San Diego, CA 92104-5002 | 2013-02-04 |
| 1942593496 | Theresa M Larson | Nurse Practitioner | 11200 W Lincoln Hwy, Mokena, IL 60448-8208 | 2011-05-17 |
| 1174764419 | Theresa Lynn Larson | Speech-Language Pathologist | 300 Cedar St, Tarkio, MO 64491-1174 | 2009-03-17 |
| 1881606739 | Theresa A Larson | Ophthalmology | 608 Stanton L Young Blvd, Oklahoma City, OK 73104-5014 | 2006-08-12 |
| Street Address |
10004 KENNERLY RD SUITE 362B |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63128-2141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053317313 | Sylvia Ann Steiling | Surgery | 10004 Kennerly Rd, Ste 137a, Saint Louis, MO 63128-2140 | 2005-06-22 |
| 1376166066 | Nhs South LLC | Internal Medicine | 10004 Kennerly Rd, Saint Louis, MO 63128-2141 | 2020-05-28 |
| 1932690567 | Kristin Leigh Wall | Registered Nurse | 10004 Kennerly Rd, Saint Louis, MO 63128-2141 | 2018-05-18 |
| 1447795695 | Laura Michler | Nurse Practitioner | 10004 Kennerly Rd, Ste 115a, Saint Louis, MO 63128-2141 | 2016-12-27 |
| 1346796562 | Jennifer Lynn Seib | Nurse Practitioner | 10004 Kennerly Rd, Ste. 255a, Saint Louis, MO 63128-2141 | 2016-08-28 |
| 1528415536 | Community & Long-term Care Psychiatry LLC | Behavioral Analyst | 10004 Kennerly Rd, Ste 362b, Saint Louis, MO 63128-2141 | 2016-05-19 |
| 1083081004 | Frank H Gafford Md, PC | Internal Medicine | 10004 Kennerly Rd, Suite 283b, Saint Louis, MO 63128-2141 | 2015-08-25 |
| 1710375340 | Sabina Smajis | Nurse Practitioner | 10004 Kennerly Rd, Saint Louis, MO 63128-2141 | 2015-01-05 |
| 1962810952 | St. Anthony's Physician Organization | Internal Medicine | 10004 Kennerly Rd, Suite 200a, Saint Louis, MO 63128-2141 | 2014-07-23 |
| 1457766255 | St. Anthony's Physician Organization | Obstetrics & Gynecology | 10004 Kennerly Rd, Ste 395b, Saint Louis, MO 63128-2141 | 2014-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841899374 | Christopher Seigel | Counselor | 5317 Mild Dr, Saint Louis, MO 63129-3109 | 2020-10-26 |
| 1467067504 | Anne Margaret Perkins | Counselor | 9733 Saint Charles Rock Rd, Saint Louis, MO 63114-2625 | 2020-09-15 |
| 1730792722 | Aryn Bostic | Counselor | 7584 Olive Blvd Ste 203, Saint Louis, MO 63130-1600 | 2020-08-28 |
| 1417568932 | Child and Family Empowerment Center | Counselor | 800 N Tucker Blvd Fl 1, Saint Louis, MO 63101-1008 | 2020-08-10 |
| 1720603830 | Kelly Marie Buckley | Counselor | 5939 Hilgard Pl, Saint Louis, MO 63109-3445 | 2020-06-15 |
| 1407479207 | Lauren Elizabeth Summers | Counselor | 6261 Reber Pl, Saint Louis, MO 63139-2617 | 2020-05-27 |
| 1306469960 | Walter Robert Scull | Counselor | 1300 Kirkham Ave, Saint Louis, MO 63122-3127 | 2020-05-18 |
| 1982226759 | David Mcgraw | Counselor | 28 Reasor Dr, Saint Louis, MO 63135-1125 | 2020-05-14 |
| 1992326565 | Chantrell M Carter | Counselor | 5027 Mardel Ave, Saint Louis, MO 63109-1731 | 2020-05-05 |
| 1508486333 | Evelyn Aviva Witten | Counselor | 130 S Bemiston Ave Ste 604, Saint Louis, MO 63105-1913 | 2020-04-22 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63128 |
Please comment or provide details below to improve the information on THERESA M. LARSON.
| 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.