NATHANAEL M LARSEN (PH.D.) – Clinical Psychologist, NPI 1912954728

NATHANAEL M LARSEN (PH.D.) is a healthcare provider. based in Fergus falls, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. LP2878 (MN). The NPI Number for NATHANAEL M LARSEN (PH.D.) is 1912954728

Main info

Male
22 Years Of Experience
Accepts Medicare Assignment
Name
NATHANAEL M LARSEN (PH.D.)
NPI
1912954728
Phone
Not provided
Address
23355 OAKVIEW HEIGHTS DR
Enumeration Date
27 May 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2187366987
Graduation Year
2004 (22 years ago)
PAC ID
8729091640
Group Practice PAC ID
1759291891
Professional Enrollment ID
I20060719000173
Address ID
MN565375505FE980XXRDXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,120 CLINICAL PSYCHOLOGIST in MN

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Provider Addresses for NATHANAEL M LARSEN (PH.D.)

  • 23355 OAKVIEW HEIGHTS DR

    FERGUS FALLS, MN 565378163

    Phone:

    Type: Mailing

  • 126, East Alcott Avenue, Fergus Falls, Otter Tail County, Minnesota, 56537, United States

    FERGUS FALLS, MN 565372903

    Phone: (218) 736-6987

    Fax: (218) 736-6980

    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.

This can happen when there are no reportable CMS Open Payments records.

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: 2006-07-19

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060719000173IClinical PsychologistMNTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes11525$0
90832Psychotherapy, 30 minutes8821$0
90791Psychiatric diagnostic evaluation1919$0
View full utilization report →

Insurance plans in this area (ZIP 56537)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1759291891View full group profile
NameSpecialtyState
-MN
-MN
Mental Health CounselorMN
Clinical Social WorkerND
Clinical Social WorkerTX
Mental Health CounselorMN
Mental Health CounselorMN
P S Y C H I A T R YMN
Mental Health CounselorMN
Nurse PractitionerMN

Reviews

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Frequently asked questions

What is the 10-digit NPI for NATHANAEL M LARSEN (PH.D.)?
NATHANAEL M LARSEN (PH.D.) — NPI 1912954728 — is the standard way to identify this listing.
Is NATHANAEL M LARSEN (PH.D.) listed as active for patients and plans?
The listing shows NATHANAEL M LARSEN (PH.D.) as active in the NPI system.
What taxonomy line describes NATHANAEL M LARSEN (PH.D.)?
For research purposes, treat NATHANAEL M LARSEN (PH.D.) as Clinical Psychologist in this dataset. Clinical services aligned with this taxonomy classification.
Where is NATHANAEL M LARSEN (PH.D.) based?
NATHANAEL M LARSEN (PH.D.) is tied to Fergus Falls, Minnesota in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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