Individual provider Active NPI

Katherine Ann Lundell, LCSW

  • Clinical Social Worker
  • Queen Creek, AZ
National Provider Identifier
1578201893
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
87223 Issued in CA
Practice address
22782 E Pegasus Pkwy
Queen Creek, AZ 85142-2484
Phone
(760) 310-1504
NPI assigned
May 25, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 87223 CA Primary

Addresses

Primary practice location

22782 E Pegasus Pkwy
Queen Creek, AZ 85142-2484

Mailing address

22782 E Pegasus Pkwy
Queen Creek, AZ 85142-2484
Phone (760) 310-1504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220819000261 CA Practitioner - Clinical Social Worker 6709269095 Reassigns benefits to 1 organization
I20241007001361 AZ Practitioner - Clinical Social Worker 6709269095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Blue Moon Senior Counseling of California LLCGroup PAC ID 9335360981, 79 clinicians
BMSC Az LLCGroup PAC ID 4385929173, 130 clinicians

Practice addresses (Care Compare)

Palm Springs, CA 92264
Phone (855) 241-7160

39905 Via Scena
Unit 218
Palm Desert, CA 92260-1827
Phone (855) 241-7160

7370 E Gold Dust Ave
Scottsdale, AZ 85258-1025
Phone (855) 241-7160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
BMSC Az LLC Clinical CurrentSince Aug 7, 2024 Accepting new patients
Blue Moon Senior Counseling of California LLC Clinical CurrentSince Jul 7, 2022 Accepting new patients

Locations

7370 E Gold Dust Ave
Scottsdale, AZ 85258
Phone (480) 609-5115

10204 Bode St
Ste B
Plainfield, IL 60585
Phone (630) 229-6462

10204 Bode St
Ste C
Plainfield, IL 60585
Phone (630) 844-7077

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1578201893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22782 E PEGASUS PKWY",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851422484",
            "telephone_number": "760-310-1504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22782 E PEGASUS PKWY",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851422484",
            "telephone_number": "760-310-1504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDELL",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-25",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "87223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

Verify at the official NPI Registry.