Active NPI
Deborah S Lung, LPC
- Mental Health Counselor
- Charlotte, NC
National Provider Identifier
1467597641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0701002600
- Practice address
- 4701 Park Rd
Charlotte, NC 28209-3217 - Phone
- (803) 431-0037
- NPI assigned
- Feb 21, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 0701002600 | VA | |
| Mental Health Counselor | 101YM0800X | 0701002600 | VA | Primary |
Addresses
Primary practice location
4701 Park Rd
Charlotte, NC 28209-3217
Mailing address
770 Petersburg Dr
Fort Mill, SC 29708-5708
Phone (803) 431-0037
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004945166 | Medicaid | VA | |
| 400231 | Other | VA | ANTHEM BLUE CROSS BLUE SH |
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 |
|---|---|---|---|
| 0701002600 | VA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372809600000",
"number": "1467597641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "770 PETERSBURG DR",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297085708",
"telephone_number": "803-431-0037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4701 PARK RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282093217",
"telephone_number": "803-431-0037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNG",
"first_name": "DEBORAH",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-21",
"last_updated": "2013-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "VA",
"license": "0701002600",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VA",
"license": "0701002600",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004945166",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS BLUE SH",
"identifier": "400231",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.