Active NPI
Leslie Gunderson, LMFT
- Marriage & Family Therapist
- Durham, NC
National Provider Identifier
1043879786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 2070
- Practice address
- 2530 Meridian Pkwy Ste 300
Durham, NC 27713-5273 - Phone
- (734) 255-3964
- NPI assigned
- Jun 6, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LCM615 | MD | |
| Marriage & Family Therapist | 106H00000X | 2070 | NC | Primary |
Addresses
Primary practice location
2530 Meridian Pkwy Ste 300
Durham, NC 27713-5273
Mailing address
2530 Meridian Pkwy Ste 300
Durham, NC 27713-5273
Phone (734) 255-3964
Other practice location 1
3708 Lyckan Pkwy
Durham, NC 27707-2586
Phone (734) 255-3964
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | leslie@jonahgreenandassociates.com |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2070 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| LCM615 | MD | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650585600000",
"number": "1043879786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2530 MERIDIAN PKWY STE 300",
"city": "DURHAM",
"state": "NC",
"postal_code": "277135273",
"telephone_number": "734-255-3964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2530 MERIDIAN PKWY STE 300",
"city": "DURHAM",
"state": "NC",
"postal_code": "277135273",
"telephone_number": "734-255-3964"
}
],
"practiceLocations": [
{
"address_1": "3708 Lyckan Pkwy",
"address_purpose": "LOCATION",
"city": "Durham",
"state": "NC",
"postal_code": "277072586",
"country_code": "US",
"telephone_number": "734-255-3964",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUNDERSON",
"first_name": "LESLIE",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-06",
"last_updated": "2022-04-22",
"certification_date": "2022-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MD",
"license": "LCM615",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NC",
"license": "2070",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "leslie@jonahgreenandassociates.com",
"affiliation": "N",
"address_1": "3930 Knowles Ave Ste 200",
"city": "Kensington",
"state": "MD",
"country_code": "US",
"postal_code": "208952428",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.