Individual provider Active NPI

Carol Joy Lundemo, M.A.

  • Mental Health Counselor
  • Shoreline, WA
National Provider Identifier
1518379809
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
60459685 Issued in WA
Practice address
1900 N 175TH St
Shoreline, WA 98133-5104
Phone
(206) 235-8587
NPI assigned
May 21, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 60459685 WA Primary

Addresses

Primary practice location

1900 N 175TH St
Shoreline, WA 98133-5104

Mailing address

121 N 76TH St
Seattle, WA 98103-4603
Phone (206) 235-8587

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
60459685WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1518379809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 N 76TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981034603",
            "telephone_number": "206-235-8587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N 175TH ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981335104",
            "telephone_number": "206-235-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDEMO",
        "first_name": "CAROL",
        "middle_name": "JOY",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-21",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "60459685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.