JENNIFER REBEKAH LARSON PHD NPI 1487665584

NPI Information

NPI: 1487665584
Provider Name: JENNIFER REBEKAH LARSON, PHD
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Individual
Address:
8406 SIX FORKS RD STE 101
RALEIGH, NC
ZIP 27615
Phone: (919) 473-6451
Get Directions

Jennifer Rebekah Larson, PHD is a clinical neuropsychologist in Raleigh, NC. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. Jennifer Rebekah Larson, PHD NPI is 1487665584. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

8406 SIX FORKS RD STE 101
RALEIGH, NC
ZIP 27615-075
Phone: (919) 473-6451
Fax: (844) 584-4207

The enumeration date for this NPI number is 8/11/2006 and was last updated on 10/15/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TC0700X	Psychologist	Clinical	2648	NORTH CAROLINA	No
2	103G00000X	Clinical Neuropsychologist		2648	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	045GA	OTHER	NORTH CAROLINA	BCBS
2	6000216	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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