Individual provider Active NPI

Alexandra Lundsteen, MS, LMFT, CADC

  • Marriage & Family Therapist
  • Rockford, IL
National Provider Identifier
1770196537
Registry record updated Aug 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166001397 Issued in IL
Practice address
1601 University Dr
Rockford, IL 61107-5317
Phone
(815) 387-2533
NPI assigned
Aug 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 33718 IL
Marriage & Family Therapist 106H00000X 166001397 IL Primary

Addresses

Primary practice location

1601 University Dr
Rockford, IL 61107-5317

Mailing address

1021 N Mulford Rd
Rockford, IL 61107-3874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240115000540 IL Practitioner - Marriage and Family Therapist 7113379264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rockford Psychiatric Medical Services SCGroup PAC ID 6901089515, 154 clinicians

Practice addresses (Care Compare)

1639 N Alpine Rd
Suite 260
Rockford, IL 61107-1481
Phone (815) 395-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
33718ILMDAddiction (Substance Use Disorder) Counselor
166001397ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Psychiatric Medical Services, S.C. CurrentSince Jan 1, 2024 Accepting new patients

Locations

1211 W 22nd St
Ste 406
Oak Brook, IL 60523

1639 N Alpine Rd
Ste 260
Rockford, IL 61107
Phone (815) 395-1500

1639 N Alpine Rd
Ste 500
Rockford, IL 61107
Phone (815) 395-1500

Organizations & group practices 1

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": "1598745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598745600000",
    "number": "1770196537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 UNIVERSITY DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075317",
            "telephone_number": "815-387-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDSTEEN",
        "first_name": "ALEXANDRA",
        "credential": "MS, LMFT, CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-30",
        "last_updated": "2020-08-30",
        "certification_date": "2020-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "33718",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166001397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.