Ryan Aidan Lundergan, LGPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

2057 Pulaski Hwy Ste 4
North East, MD 21901-3744

Phone

(443) 877-4044

NPI assigned

Aug 16, 2022

Sex

Male

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 MD

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stride Forward Counseling LLCGroup PAC ID 9537528328, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Stride Forward Counseling LLC

  • Adult Mental Health Clinic/Center
  • Catonsville, MD
  • NPI 1881209815
  Medicare reassignment Care Compare group
• Jesse Fairchild LLC

  • Mental Health Counselor
  • North East, MD
  • NPI 1467724013

  Professional

  NPD

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1184342172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 ROGER VALLEY CT",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212341442",
            "telephone_number": "443-766-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2057 PULASKI HWY STE 4",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219013744",
            "telephone_number": "443-877-4044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Roger Valley Ct",
            "address_purpose": "LOCATION",
            "city": "Parkville",
            "state": "MD",
            "postal_code": "212341442",
            "country_code": "US",
            "telephone_number": "443-766-9018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUNDERGAN",
        "first_name": "RYAN",
        "middle_name": "AIDAN",
        "credential": "LGPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David A Leatherwood, D.D.S.
• Danielle Brittany Lee, LGPC
• Jessica Lee
• Kayla Paige Lipson, LGPC
• Dawn Loewenstein, LMSW
• Lori N Lusk, DPT
• Maryland Sportscare & Rehab LLC
• Mark Mathews, MA, LGPC, NCC
• Jeffrey Eades Maupin, P. T.
• Kenduanyi Menkem

• Professional Counselor in North East, MD
• Providers in North East, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.