Active NPI
Sandra Lynn Lundberg, PSY.D.
- Psychologist
- Colorado Springs, CO
National Provider Identifier
1083822399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2505
- Practice address
- 6165 Lehman Dr
Suite 106
Colorado Springs, CO 80918-3441 - Phone
- (719) 641-3880
- NPI assigned
- May 18, 2007
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2505 | CO | Primary |
Addresses
Primary practice location
6165 Lehman Dr
Suite 106
Colorado Springs, CO 80918-3441
Mailing address
4797 Spotted Horse Dr
Colorado Springs, CO 80918-5195
Phone (719) 262-9813
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 |
|---|---|---|---|
| 2505 | CO | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083822399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4797 SPOTTED HORSE DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809185195",
"telephone_number": "719-262-9813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6165 LEHMAN DR",
"address_2": "SUITE 106",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809183441",
"telephone_number": "719-641-3880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDBERG",
"first_name": "SANDRA",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CO",
"license": "2505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.