DR. KENNETH A LARSEN (DMIN, PHD, ABMP) – Clinical Psychologist, NPI 1053343707
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,700 CLINICAL PSYCHOLOGIST in MA
Provider Addresses for DR. KENNETH A LARSEN (DMIN, PHD, ABMP)
500 Victory Rd Ste 3
Quincy, MA 021713132
Phone: (617) 413-2328
Fax: (617) 334-7845
Type: Location
34 N ELDORADO AVE
BOZEMAN, MT 597181229
Phone: (617) 413-2328
Fax: (617) 334-7845
Type: Location
162, Dodge Road, Leightons Corner, Rowley, Essex County, Massachusetts, 01969, United States
ROWLEY, MA 019692211
Phone: (617) 413-2328
Fax: (617) 754-5444
Type: Mailing
20, Guest Street, North Brighton, Brighton, Boston, Suffolk County, Massachusetts, 02135, United States
STE 225
BRIGHTON, MA 021352065
Phone: (617) 754-5160
Fax: (617) 750-5444
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-11-23
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20111123000473 | I | Clinical Psychologist | MA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 02171)
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