Active NPI
Alexandra Lundberg, LPCA
- Professional Counselor
- Winston Salem, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A12807
- Practice address
- 650 Highland Ave Ste 100
Winston Salem, NC 27101-4304 - Phone
- (336) 607-8523
- NPI assigned
- Jun 12, 2018
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A12807 | NC | |
| Professional Counselor | 101YP2500X | A12807 | NC | Primary |
Addresses
Primary practice location
650 Highland Ave Ste 100
Winston Salem, NC 27101-4304
Mailing address
284 Executive Park Dr Ste 100
Concord, NC 28025-1833
Phone (704) 939-1100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A12807 | NC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daymark Recovery Services, Inc. | Mental Health | Current | Accepting new patients |
Locations
284 Executive Park Dr
Ste 100
Kannapolis, NC 28025
Phone (704) 939-1118
1104A S Main St
Lexington, NC 27292
Phone (336) 300-8836
2129 Statesville Blvd
Salisbury, NC 28147
Phone (704) 633-3616
650 Highland Ave
Ste 100
Winston Salem, NC 27101
Phone (336) 606-8523
650 Highland Ave
Ste 110
Winston Salem, NC 27101
Phone (336) 597-2115
Interoperability endpoints
- alexandra.lundberg.p1@direct.daymarkrecovery.nextgenshare.com
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Concord, NC
- NPI 1558329243
Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580169600000",
"number": "1265925465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "284 EXECUTIVE PARK DR STE 100",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251833",
"telephone_number": "704-939-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 HIGHLAND AVE STE 100",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271014304",
"telephone_number": "336-607-8523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDBERG",
"first_name": "ALEXANDRA",
"credential": "LPCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-12",
"last_updated": "2020-01-28",
"certification_date": "2020-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A12807",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A12807",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.