NPIMap

Organization Active NPI

Lakeside Counseling Services

  • Professional Counselor
  • O'Fallon, MO
National Provider Identifier
1083423453
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
LAKESIDE COUNSELING SERVICES
Practice address
1031A Peruque Crossing CT
O Fallon, MO 63366-2384
Phone
(636) 887-3655
Fax
(636) 887-3655
NPI assigned
Dec 31, 2024
Last updated
Dec 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Authorized official

Name
Nathan Lundin, LPCNPI 1659326015
Title
Owner
Phone
(636) 887-3655

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

1031A Peruque Crossing CT
O Fallon, MO 63366-2384

Mailing address

1031A Peruque Crossing CT
O Fallon, MO 63366-2384
Phone (636) 887-3655

National Provider Directory

National Provider Directory

Locations

1031A Peruque Crossing Ct
O Fallon, MO 63366
Phone (636) 887-3655

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1735603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735603200000",
    "number": "1083423453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031A PERUQUE CROSSING CT",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633662384",
            "telephone_number": "636-887-3655",
            "fax_number": "636-887-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031A PERUQUE CROSSING CT",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633662384",
            "telephone_number": "636-887-3655",
            "fax_number": "636-887-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-31",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A",
        "authorized_official_last_name": "LUNDIN",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-887-3655",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.