MR. KURT DOMINICK LAROSE (LCSW, LICSW) – Clinical Social Worker, NPI 1023221967

MR. KURT DOMINICK LAROSE (LCSW, LICSW) is a healthcare provider. based in Perryville, Missouri. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW, LICSW. They hold a License No. SW9297 (FL). The NPI Number for MR. KURT DOMINICK LAROSE (LCSW, LICSW) is 1023221967

Main info

Male
Sole Proprietor
23 Years Of Experience
Accepts Medicare Assignment
Name
MR. KURT DOMINICK LAROSE (LCSW, LICSW)
NPI
1023221967
Phone
(573) 547-3116
Address
12 N KINGS HWY STE 101
Enumeration Date
7 May 2007
Last Update Date
24 February 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5735472536
Graduation Year
2003 (23 years ago)
PAC ID
8325180540
Group Practice PAC ID
1153777826
Professional Enrollment ID
I20200819003267
Address ID
MO637751359PE434XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience80
Completeness75
Years active:19State licenses:3Digital endpointsOther names

1,245 CLINICAL SOCIAL WORKER in MO

Provider Addresses for MR. KURT DOMINICK LAROSE (LCSW, LICSW)

  • 12 N KINGS HWY STE 101

    PERRYVILLE, MO 637751367

    Phone: (573) 547-3116

    Fax: (573) 547-2963

    Type: Location

  • 700 12TH ST NW STE 700

    WASHINGTON, DC 200054052

    Phone: (850) 545-2886

    Type: Mailing

  • 12 N KINGSHIGHWAY ST STE 101

    PERRYVILLE, MO 637751367

    Phone: (850) 545-2886

    Type: Mailing

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: 2020-08-19

PECOS data refreshed: 2026-05-27

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
I20200819003267IClinical Social WorkerMOTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63775)

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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: 1153777826View full group profile
NameSpecialtyState
Nurse PractitionerMO
Nurse PractitionerMO
Diagnostic RadiologyTN
Diagnostic RadiologyMO
Pain Management, Anesthesiology, Anesthesiology, Pain ManagementMO
Diagnostic RadiologyMO
Diagnostic RadiologyMO
Diagnostic RadiologyMO
Nurse PractitionerMO
Nurse PractitionerMO

Reviews

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Frequently asked questions

What is the registry number for MR. KURT DOMINICK LAROSE (LCSW, LICSW)?
The registry entry for MR. KURT DOMINICK LAROSE (LCSW, LICSW) shows NPI 1023221967.
Is MR. KURT DOMINICK LAROSE (LCSW, LICSW) currently accepting referrals based on NPI status?
Registry metadata lists MR. KURT DOMINICK LAROSE (LCSW, LICSW) as active.
How should patients interpret MR. KURT DOMINICK LAROSE (LCSW, LICSW)'s specialty?
The extract shows Clinical Social Worker for MR. KURT DOMINICK LAROSE (LCSW, LICSW). Clinical services aligned with this taxonomy classification.
What geographic area is tied to MR. KURT DOMINICK LAROSE (LCSW, LICSW)?
MR. KURT DOMINICK LAROSE (LCSW, LICSW) is associated with Perryville, Missouri in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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