Deette Lundberg, LAT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LAT-345 Issued in WY

Practice address

231 S Wilson St
Casper, WY 82601-2941

Phone

(307) 265-3791

Fax

(307) 265-4480

NPI assigned

Feb 5, 2020

Last updated

Feb 5, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• S48Wy1, LLC

  dba Wyoming Recovery

  • Substance Abuse Rehabilitation Facility
  • Casper, WY
  • NPI 1891994950
  Medicare reassignment NPD
• Wyoming Recovery Rawlins

  dba Wyoming Recovery

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Rawlins, WY
  • NPI 1528657590
  NPD

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1124650486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 S WILSON ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012941",
            "telephone_number": "307-265-3791",
            "fax_number": "307-265-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 S WILSON ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012941",
            "telephone_number": "307-265-3791",
            "fax_number": "307-265-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDBERG",
        "first_name": "DEETTE",
        "credential": "LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WY",
            "license": "LAT-345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lsref Golden Ops 14 (Wy) LLC (Meadow Wind Assisted Living)
• Marko Lubardic, MD
• Frances Lee Lujan, LCSW
• Netsanet Lundahl, MD
• Lundberg Consultant Services PC
• Sophia Lybrand, RN
• DJ Lyles
• Laurie Ann Lyon
• Rebecca Mabie, DO
• Anne M Macguire, M.D.

• Addiction (Substance Use Disorder) Counselor in Casper, WY
• Providers in Casper, WY by specialty
• Addiction (Substance Use Disorder) Counselor in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.