Individual provider Active NPI

Sharon Lundberg, LPC

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1720822323
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
88692 Issued in TX
Practice address
803 Castroville Rd Ste 134
San Antonio, TX 78237-3148
Phone
(210) 436-2339
Fax
(210) 436-2329
NPI assigned
Jun 19, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 88692 TX Primary

Addresses

Primary practice location

803 Castroville Rd Ste 134
San Antonio, TX 78237-3148

Mailing address

9534 Nueces Cyn
San Antonio, TX 78251-3577
Phone (808) 291-8477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240730002635 TX Practitioner - Mental Health Counselor 8628515491 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
88692TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Evidence of Grace Counseling Center CurrentSince Apr 29, 2024 Accepting new patients
Evidence of Grace Counseling Center PastSince Apr 29, 2024 Accepting new patients

Locations

803 Castroville Rd
Ste 134
San Antonio, TX 78237
Phone (210) 436-2339

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": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1720822323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9534 NUECES CYN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782513577",
            "telephone_number": "808-291-8477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 CASTROVILLE RD STE 134",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782373148",
            "telephone_number": "210-436-2339",
            "fax_number": "210-436-2329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDBERG",
        "first_name": "SHARON",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "88692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.