Jeffrey Sundberg, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH 10368 Issued in FL

Practice address

915 Middle River Dr
Suite 317
Fort Lauderdale, FL 33304-3544

Phone

(954) 812-6965

NPI assigned

Aug 6, 2010

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Berkeley Therapy Institute

  • Psychiatry Physician
  • Berkeley, CA
  • NPI 1255497814
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1281052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281052800000",
    "number": "1013222678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 MIDDLE RIVER DR",
            "address_2": "SUITE 317",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 MIDDLE RIVER DR",
            "address_2": "SUITE 317",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043544",
            "telephone_number": "954-812-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDBERG",
        "first_name": "JEFFREY",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-06",
        "last_updated": "2010-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "MH 10368",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "MH 10368",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 10368",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH 10368",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sun Hyperbarics LLC
• Sun Medical Solutions LLC
• Sun View Medical Services PA
• Sunbelt Medical Billings Inc
• Sundaysshops, LLC
• Sunil Ayyagari MD PLLC
• Gabriel Lemuel Sunn Felsen, MD
• Rania Anwar Sunna
• Sunny Reign LLC
• Sunpoint Surgical

• Mental Health Counselor in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.