ANDREA SUSAN LARSEN PHD
NPI 1811050248
Psychologist in Minneapolis, MN

Active since December 18, 2006Opted out of Medicare · through Aug 10, 2027
430 OAK GROVE SUITE #230, LORING PARK OFFICE BUILDING, MINNEAPOLIS, MN 55403(612) 870-0230(612) 872-9170 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Andrea Susan Larsen Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDREA SUSAN LARSEN PHD (NPI 1811050248) is an individual psychologist in Minneapolis, Minnesota, licensed in Minnesota (0120) and active in the NPI registry since December 2006. She has opted out of Medicare through August 10, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1811050248
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameANDREA SUSAN LARSENCredential: PHD
Location Address430 OAK GROVE SUITE #230, LORING PARK OFFICE BUILDINGMinneapolis, MN 55403-3253
Mailing Address430 Oak Grove Suite #230, Loring Park Office BuildingMinneapolis, MN 55403-3253 · (612) 870-0230 · Fax (612) 872-9170
Fax(612) 872-9170
Sole ProprietorNo
Enumeration DateDecember 18, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1811050248 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Licenses Licensed in MN · 0120 Licensed in MN · LP1082
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Other Identifiers 1

Other59681LABc

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Andrea Susan Larsen Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 10, 2015 through August 10, 2027.

Opt-Out Effective DateAugust 10, 2015
Opt-Out In Effect ThroughAugust 10, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Andrea Larsen's NPI number?

The NPI number for Andrea Larsen is 1811050248. It was assigned to this individual provider in the NPPES registry on December 18, 2006.

Where is Andrea Larsen located?

Andrea Larsen practices at 430 Oak Grove Suite #230 Loring Park Office Building, Minneapolis, MN 55403. The listed phone number is (612) 870-0230.

What is Andrea Larsen's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Andrea Larsen enrolled in Medicare?

No. Andrea Larsen has opted out of Medicare through August 10, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Andrea Larsen was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.