Individual provider Active NPI

Cheryl Lynn Lundsgaard, ACSW, LICSW

  • Clinical Social Worker
  • Minnetonka, MN
National Provider Identifier
1750457446
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12987 Issued in MN
Practice address
3395 Plymouth Rd
Minnetonka, MN 55305-3765
Phone
(952) 939-0396
Fax
(952) 548-8760
NPI assigned
Nov 27, 2006
Last updated
Jan 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12987 MN Primary
Clinical Social Worker 1041C0700X 01028 IA

Addresses

Primary practice location

3395 Plymouth Rd
Minnetonka, MN 55305-3765

Mailing address

8141 W 103Rd St
Bloomington, MN 55438-1913

Other identifiers 1

IdentifierTypeStateIssuer
334827000MedicaidMN

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
12987MNMDClinical Social Worker
01028IAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1750457446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8141 W 103RD ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554381913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3395 PLYMOUTH RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553053765",
            "telephone_number": "952-939-0396",
            "fax_number": "952-548-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDSGAARD",
        "first_name": "CHERYL",
        "middle_name": "LYNN",
        "credential": "ACSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "12987",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "01028",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "334827000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; 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.