MRS. DEBORAH DIANE LARSON (NPI# 1588954812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588954812 |
| Entity Type | Individual |
| Full Name | MRS. DEBORAH DIANE LARSON |
| Credential | LADC |
| Practice Address |
645 3rd Ave Sw Pine City MN 55063-1468 |
| Practice Telephone | 3206291362 |
| Practice Fax Number | 3206293454 |
| Mailing Telephone | 3206291362 |
| Mailing Fax Number | 3206293454 |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2011-04-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
301810 | MN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730138140 | Deborah Compel Larson | Registered Nurse | Huntington Memorial Hospital, 100 W California Blvd, Pasadena, CA 91109-7013 | 2006-05-10 |
| 1942779012 | Deborah Earleen Larson | Home Health | 2152 Stage Coach Rd, Webster City, IA 50595-7370 | 2018-11-19 |
| 1760525570 | Deborah Jayne Larson | Speech-Language Pathologist | 3724 Jefferson St, Ste. 316, Austin, TX 78731-6225 | 2007-02-14 |
| 1205876224 | Deborah Larson | Nurse Anesthetist, Certified Registered | 6401 France Ave S, Edina, MN 55435-2104 | 2006-06-07 |
| 1730154212 | Deborah A Larson | Nurse Practitioner | 410 W 10th Ave, Columbus, OH 43210-1240 | 2006-02-20 |
| Street Address |
645 3RD AVE SW |
| City | PINE CITY |
| State | MN |
| Zip Code | 55063-1468 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538511316 | Leone Anderson | Counselor | 645 3rd Ave Sw, Pine City, MN 55063-1443 | 2016-07-06 |
| 1932492907 | Kelly Andersen | Counselor | 645 3rd Ave Sw, Pine City, MN 55063-1443 | 2011-05-24 |
| 1912297474 | Marilyn Jean Pedersen | Counselor | 645 3rd Ave Sw, Pine City, MN 55063-1468 | 2011-04-18 |
| 1760772586 | Del Gene Bacon | Counselor | 645 3rd Ave Sw, Pine City, MN 55063-1468 | 2011-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861025595 | B&b Guardian Angels Home Care Services, Inc | Home Health | 27680 Beroun Crossing Road, Pine City, MN 55063 | 2020-02-21 |
| 1346684289 | Power Chairs and Scooter Store Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 540 Main St S, Pine City, MN 55063 | 2013-04-22 |
| 1225387327 | Avalon Meridian Behavioral Health | Health Maintenance Organization | 645 3rd Avenue Sw, Pine City, MN 55063 | 2012-09-05 |
| 1629226949 | Community Supports Programming Services LLC | Home Health | 500 3rd Ave Se, Suite 2, Pine City, MN 55063 | 2008-08-28 |
| 1033233788 | Meadow Creek LLC | Substance Abuse Rehabilitation Facility | 17305 Meadow Creek Lane, Pine City, MN 55063 | 2007-03-19 |
| 1477647006 | Rachel E Waxberg | Chiropractor | 805 Main Street South, Pine City, MN 55063 | 2006-10-03 |
| 1306947494 | Joseph Norbert Nilsson | Chiropractor | 253 5th St Se, Pine City, MN 55063 | 2006-09-25 |
| 1851324313 | Pine Eye Associates, Pa | Optometrist | 110 Evergreen Square, Pine City, MN 55063 | 2006-07-08 |
| 1053372656 | Kristie Ann Roberts | Dentist | 1105 Hillside Ave Sw, Pine City, MN 55063 | 2006-03-31 |
| 1114495827 | Kelly Ann Buchta | Social Worker | 220 Railroad St Se, Pine City, MN 55063 | 2018-11-12 |
| Find all providers in zip 55063 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679039168 | Tracie Houle | Counselor | 220 Railroad St Se, Pine City, MN 55063-1540 | 2019-02-20 |
| 1538511316 | Leone Anderson | Counselor | 645 3rd Ave Sw, Pine City, MN 55063-1443 | 2016-07-06 |
| 1417321696 | Jessica Juel Weidert | Counselor | 220 Railroad St Se, Pine City, MN 55063-1540 | 2015-11-25 |
| 1407149396 | Shelley Ann Skarda | Counselor | 17305 Meadow Creek Lane, Pine City, MN 55063 | 2011-05-25 |
| 1063705929 | Marianne Bernadette Thiry | Counselor | 17305 Meadow Creek Lane, Pine City, MN 55063 | 2011-05-25 |
| 1932492907 | Kelly Andersen | Counselor | 645 3rd Ave Sw, Pine City, MN 55063-1443 | 2011-05-24 |
| 1912297474 | Marilyn Jean Pedersen | Counselor | 645 3rd Ave Sw, Pine City, MN 55063-1468 | 2011-04-18 |
| 1760772586 | Del Gene Bacon | Counselor | 645 3rd Ave Sw, Pine City, MN 55063-1468 | 2011-04-13 |
| 1316151335 | Avalon - Pine City | Counselor | 655 3rd Ave Sw, Pine City, MN 55063-1443 | 2007-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386456 | Alexandra Lloyd Conroy | Counselor | 3227 Lake Shore Boulevard, Minnetonka, MN 55391 | 2020-11-07 |
| 1134720212 | Rachel Renee Przekwas | Counselor | 216 Center St W Ste 101, Roseau, MN 56751-1494 | 2020-11-04 |
| 1568062461 | Andrew Moe | Counselor | 2118 Blaisdell Ave S., Minneapolis, MN 55404 | 2020-10-29 |
| 1215537477 | Hannah Mae Kidder | Counselor | 1605 Welcome Ave N, Golden Valley, MN 55422-4429 | 2020-10-27 |
| 1649879339 | Jordan Lowe | Counselor | 4615 Grand Ave Ste 300, Duluth, MN 55807-2749 | 2020-10-22 |
| 1417556762 | Jacob R Poppinga | Counselor | 13045 Falcon Dr Ste 7404th, Baxter, MN 56425-4201 | 2020-10-19 |
| 1598362014 | Jeremy Krekula | Counselor | 102 Main St N Ste 100, Stewartville, MN 55976-2608 | 2020-10-07 |
| 1235736786 | Catherine Ann Jaksha | Counselor | 1180 Cushing Cir Apt 217, Saint Paul, MN 55108-5016 | 2020-10-07 |
| 1952908881 | Sutton Outpatient Services, LLC | Counselor | 1700 Livingston Ave Ste 120, West St Paul, MN 55118-5938 | 2020-10-05 |
| 1750998423 | Recovery Alliance Duluth | Counselor | 206 W 4th St Ste 203, Duluth, MN 55806-2659 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
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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.