Jennifer D Lundgren, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2400 Issued in KS

Practice address

8400 W 110TH St
Ste. 610
Overland Park, KS 66210-2331

Phone

(913) 631-3800

Fax

(913) 948-7317

NPI assigned

May 26, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 11, 2017 through Apr 11, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Victoria F Young, LLC

  • Clinical Social Worker
  • Overland Park, KS
  • NPI 1073988416
  NPD (past)

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1407204860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 CHERRY ST",
            "address_2": "ROOM 321",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641102232",
            "telephone_number": "816-235-5384",
            "fax_number": "816-235-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 W 110TH ST",
            "address_2": "STE. 610",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102331",
            "telephone_number": "913-631-3800",
            "fax_number": "913-948-7317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDGREN",
        "first_name": "JENNIFER",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-26",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "2400",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2006036651",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lumicare Hospice, LLC
• Luminous Counseling
• Courtney Luna
• Laura D Lund, DPT
• Stephen B. Lund, M.D.
• Mikealee Hope Lundgren, PHARMD
• Laurie Lundquist, LCSW-R
• Brenda Lunnie-Jobe, LPC
• Michael Vien Luong
• Katherine Marie Lurk, PHARM.D.

• Clinical Psychologist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Clinical Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.