Individual provider Active NPI

Carol L. Lundwall, CPCI

  • Mental Health Counselor
  • Salt Lake City, UT
National Provider Identifier
1568601201
Registry record updated Feb 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4925810-6009 Issued in UT
Practice address
3809 S West Temple Ste 1B
Salt Lake City, UT 84115-4479
Phone
(801) 268-4454
Fax
(801) 268-2176
NPI assigned
Feb 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2009

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 4925810-6009 UT Primary

Addresses

Primary practice location

3809 S West Temple Ste 1B
Salt Lake City, UT 84115-4479

Mailing address

4150 S 300 E Apt 524
Salt Lake City, UT 84107-2416
Phone (801) 949-2591

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

LicenseStateTypeSpecialty
4925810-6009UTMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235001600000",
    "number": "1568601201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 S 300 E APT 524",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072416",
            "telephone_number": "801-949-2591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3809 S WEST TEMPLE STE 1B",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841154479",
            "telephone_number": "801-268-4454",
            "fax_number": "801-268-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDWALL",
        "first_name": "CAROL",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "CPCI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-19",
        "last_updated": "2009-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "4925810-6009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; 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.