Derek Larsen, LMFT - Medicare Couples Therapy in Provo, UT

Derek Larsen, LMFT is a medicare enrolled "Marriage & Family Therapist" provider in Provo, Utah. His current practice location is 750 N Freedom Blvd Ste 300, Provo, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 373-4760.

Derek Larsen is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1679950166.

Contact Information

Derek Larsen, LMFT
750 N Freedom Blvd Ste 300,
Provo, UT 84601-1690
(801) 373-4760
(801) 373-0639

Healthcare Provider's Profile

Full NameDerek Larsen
GenderMale
SpecialityMarriage & Family Therapist
Location750 N Freedom Blvd Ste 300, Provo, Utah
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1679950166
  • Provider Enumeration Date: 05/04/2015
  • Last Update Date: 07/21/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 5890143382
  • Enrollment ID: I20231121003585

Medical Identifiers

Medical identifiers for Derek Larsen such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1679950166NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
106H00000XMarriage & Family Therapist (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Derek Larsen allows following entities to bill medicare on his behalf.
Entity NameWasatch Behavioral Health Special Service District
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1356357115
PECOS PAC ID: 2567367915
Enrollment ID: O20031129000014

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Derek Larsen is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Derek Larsen, LMFT
750 N Freedom Blvd Ste 300,
Provo, UT 84601-1690

Ph: (801) 373-4760
Derek Larsen, LMFT
750 N Freedom Blvd Ste 300,
Provo, UT 84601-1690

Ph: (801) 373-4760

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Marriage & Family Therapist in Provo, UT

Dr. Shayne Anderson, PH.D.
Couples Therapy
Medicare: Not Enrolled in Medicare
Practice Location: 262 Taylor Building, Brigham Young University, Provo, UT 84602
Phone: 801-422-6416    
Mr. Mark J Mauzy, MS
Couples Therapy
Medicare: Not Enrolled in Medicare
Practice Location: 755 S 400 W, Provo, UT 84601
Phone: 801-422-7620    
Tabitha Nicole Webster,
Couples Therapy
Medicare: Not Enrolled in Medicare
Practice Location: 750 N Freedom Blvd, Provo, UT 84601
Phone: 801-373-4760    
Gary Barlow Lundberg, M.A. - LMFT
Couples Therapy
Medicare: Not Enrolled in Medicare
Practice Location: 3680 Little Rock Dr, Provo, UT 84604
Phone: 801-224-3447    Fax: 800-122-4345
Mr. Adrian Kupper Baures, MFTI
Couples Therapy
Medicare: Not Enrolled in Medicare
Practice Location: 151 S University Ave, Suite 1400, Provo, UT 84601
Phone: 801-851-7127    Fax: 801-851-7186
Boone R Christianson, LMFT
Couples Therapy
Medicare: Not Enrolled in Medicare
Practice Location: 3210 N Canyon Rd Ste 204, Provo, UT 84604
Phone: 385-241-1046    
April Knight, ALMFT
Couples Therapy
Medicare: Medicare Enrolled
Practice Location: 750 N Freedom Blvd, Provo, UT 84601
Phone: 801-373-4760    Fax: 801-373-0639

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