Emma Grace Larson, PhD
Psychologist in Washington, DC. Individual provider (NPI-1).
NPI number1053933705
StatusActive
Last updated in NPPESMar 4, 2024
Details
- NPI
- 1053933705
- Entity type
- Individual (NPI-1)
- Name
- Emma Grace Larson
- Credential
- PhD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 15, 2020
- Certification date
- Mar 4, 2024
- Last updated
- Mar 4, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CLINICAL PSYCHOLOGIST
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | PSY200001381 | DC | Yes |
| 103T00000X | Psychologist | 06938 | MD |
Practice location
4801 Sargent Rd NeWashington, DC 20017-2841
Phone 202-650-6361 · Fax 202-250-6362
Mailing address
4801 Sargent Rd NeWashington, DC 20017-2841
Phone 202-650-6361 · Fax 202-250-6362
Other practice locations
13460 Walsh Dr
Boys Town, NE 68010-7529
Boys Town, NE 68010-7529
Phone 531-355-3358 · Fax 531-355-3375
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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