SHYLENE LARSON (NPI# 1225456106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225456106 |
| Entity Type | Individual |
| Full Name | SHYLENE LARSON |
| Credential | MA |
| Practice Address |
1600 S Main St Lebanon OR 97355-3109 |
| Practice Telephone | 5414515932 |
| Mailing Telephone | 5414515932 |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2014-03-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TF0200X |
Psychologist Specialization: Forensic |
Behavioral Health & Social Service Providers |
| Street Address |
1600 S MAIN ST |
| City | LEBANON |
| State | OR |
| Zip Code | 97355-3109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720068182 | Carolyn Mae Moore | Social Worker | 1600 S Main St, Lebanon, OR 97355-3109 | 2006-01-20 |
| 1730654237 | Shellany Jean Cushner | Social Worker | 1600 S Main St, Lebanon, OR 97355-3109 | 2018-10-10 |
| 1003329434 | Wendy Hull | Counselor | 1600 S Main St, Lebanon, OR 97355-3109 | 2017-11-07 |
| 1356792428 | Lavanya Kancherla | Social Worker | 1600 S Main St, Lebanon, OR 97355-3109 | 2016-06-29 |
| 1538525431 | Geoffrey Thoma | Counselor | 1600 S Main St, Lebanon, OR 97355-3109 | 2016-01-07 |
| 1265800429 | Melissa Wilson | Social Worker | 1600 S Main St, Lebanon, OR 97355-3109 | 2015-09-04 |
| 1558737866 | Joanna Means | Counselor | 1600 S Main St, Lebanon, OR 97355-3109 | 2015-08-20 |
| 1174941058 | Lisa Burner | Counselor | 1600 S Main St, Lebanon, OR 97355-3109 | 2014-03-28 |
| 1619249158 | Kenneth Mackie | Social Worker | 1600 S Main St, Lebanon, OR 97355-3109 | 2012-01-30 |
| 1407144827 | Helen Pearl Kelley | Counselor | 1600 S Main St, Lebanon, OR 97355-3109 | 2011-07-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710516182 | Patricia Hoangphuong Nguyen | Student in an Organized Health Care Education/Training Program | Western University of Health Sciences Comp-northwest, 200 Mullins Drive, Lebanon, OR 97355 | 2020-04-07 |
| 1528609740 | Liana Beaty | Technician | 31231 Mccraven Ln, Lebanon, OR 97355 | 2019-09-30 |
| 1710465323 | Jackie Welter | Health Educator | 35 Mullins Drvie Ste 3, Lebanon, OR 97355 | 2018-08-06 |
| 1518415371 | Kathleen Hillary | Registered Nurse | 525 North Santiam Highway, Lebanon, OR 97355 | 2016-09-21 |
| 1861849283 | Emily Marshall | Student in an Organized Health Care Education/Training Program | 200 Mullins Drive, Lebanon, OR 97355 | 2016-05-16 |
| 1033565551 | Celeste Maxine Croy-baker | Student in an Organized Health Care Education/Training Program | 200 Mullins Dr., Lebanon, OR 97355 | 2016-05-13 |
| 1770956963 | Jeff Parsons | Occupational Therapist | 600 Ne 5th St, Oregon Veterans Home, Lebanon, OR 97355 | 2015-11-10 |
| 1003289588 | Hong Ngoc Nguyen | Pharmacist | 675 N Fifth Street, Lebanon, OR 97355 | 2015-11-05 |
| 1801278049 | Darrel A Decker | Skilled Nursing Facility | 350 8th Street, Lebanon, OR 97355 | 2015-06-24 |
| 1679985113 | State of Oregon Department of Veterans' Affairs | Skilled Nursing Facility | 600 N. 5th Street, Lebanon, OR 97355 | 2014-06-02 |
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| Taxonomy Code | 103TF0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Forensic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114454360 | Jennifer Hegg | Psychologist | 4438 Ne 90th Ave, Portland, OR 97220-5022 | 2017-05-18 |
| 1538565890 | Pamela Suzanne Buchanan | Psychologist | 1130 Sw Morrison St Ste 520, Portland, OR 97205-2216 | 2014-11-14 |
| 1508139601 | Scott Alan Senn | Psychologist | 235 E 3rd St Ste 4, Mcminnville, OR 97128-4829 | 2012-02-20 |
| 1750521258 | Alexander Maxwell Millkey | Psychologist | 6711 N Albina Ave, Portland, OR 97217-1825 | 2009-02-24 |
| 1427251727 | David Allen Oas | Psychologist | 508 Tucker St, Ashland, OR 97520-1582 | 2007-06-06 |
| 1790813079 | Eric Mitchell Johnson | Psychologist | 1942 Nw Kearney St Ste 21, Portland, OR 97209-1463 | 2007-03-01 |
| 1104909894 | David Michael Corey | Psychologist | 5285 Meadows Road, Suite 311, Lake Oswego, OR 97035-3367 | 2006-10-24 |
| 1689284739 | Nicole Humphrey | Psychologist | 2600 Center St Ne, Salem, OR 97301-2669 | 2020-08-04 |
| 1689200784 | Sophia Jaeger-manson | Psychologist | 2600 Center St Ne, Salem, OR 97301-2669 | 2020-03-20 |
| 1811529357 | Leah Marie Glass | Psychologist | 2600 Center St Ne, Salem, OR 97301-2669 | 2020-02-11 |
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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.