Active NPI
Alexandra Runde, M.ED.
- Mental Health Counselor
- Port St Lucie, FL
National Provider Identifier
1023387651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH 11040
- 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, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| MH 11040 | FL | MD | Mental 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.