Individual provider Active NPI

Cynthia Lu Lemelin, CADC-II-CA, RAS

  • Addiction (Substance Use Disorder) Counselor
  • San Bernardino, CA
National Provider Identifier
1760806962
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
360004BN Issued in CA
Practice address
1115 N D St
San Bernardino, CA 92410-3523
Phone
(909) 888-6956
Fax
(909) 885-6758
NPI assigned
Feb 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 360004BN CA Primary

Addresses

Primary practice location

1115 N D St
San Bernardino, CA 92410-3523

Mailing address

1100 N D St
San Bernardino, CA 92410-3524
Phone (909) 991-3039

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
360004BNCAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Varp, Inc. CurrentSince May 12, 2024 Accepting new patients
Veterans Alcohol Rehabilitation Program, Inc.- Varp, Inc. Past Accepting new patients

Locations

1115 N D St
San Bernardino, CA 92410
Phone (909) 888-6956

1100 N D St
San Bernardino, CA 92410
Phone (909) 884-0840

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1391731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1760806962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N D ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103524",
            "telephone_number": "909-991-3039",
            "fax_number": "909-885-6758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 N D ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103523",
            "telephone_number": "909-888-6956",
            "fax_number": "909-885-6758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMELIN",
        "first_name": "CYNTHIA",
        "middle_name": "LU",
        "name_prefix": "Mrs.",
        "credential": "CADC-II-CA, RAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-07",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "360004BN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; 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.