Individual provider Active NPI

Alexandra Runde, M.ED.

  • Mental Health Counselor
  • Port St Lucie, FL
National Provider Identifier
1023387651
Registry record updated Feb 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 11040 Issued in FL
Practice address
1555 St. Lucie West Blvd.
Suite 201
Port St. Lucie, FL 34986
Phone
(772) 812-0292
Fax
(772) 878-7218
NPI assigned
Dec 28, 2011
Last updated
Feb 28, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH 11040 FL Primary

Addresses

Primary practice location

1555 St. Lucie West Blvd.
Suite 201
Port St. Lucie, FL 34986

Mailing address

1555 St. Lucie West Blvd.
Suite 201
Port St. Lucie, FL 34986
Phone (772) 812-0292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
MH 11040FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1325030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330387200000",
    "number": "1023387651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 ST. LUCIE WEST BLVD.",
            "address_2": "SUITE 201",
            "city": "PORT ST. LUCIE",
            "state": "FL",
            "postal_code": "34986",
            "telephone_number": "772-812-0292",
            "fax_number": "772-878-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 ST. LUCIE WEST BLVD.",
            "address_2": "SUITE 201",
            "city": "PORT ST. LUCIE",
            "state": "FL",
            "postal_code": "34986",
            "telephone_number": "772-812-0292",
            "fax_number": "772-878-7218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNDE",
        "first_name": "ALEXANDRA",
        "name_prefix": "Mrs.",
        "credential": "M.ED.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-28",
        "last_updated": "2012-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 11040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.