Active NPI
Shannon M Lundin, LADC
- Addiction (Substance Use Disorder) Counselor
- Danvers, MA
National Provider Identifier
1790592061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 23607
- Practice address
- 85 Constitution LN
Danvers, MA 01923-3694 - Phone
- (617) 320-9058
- NPI assigned
- Dec 11, 2024
- Last updated
- Dec 11, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 23607 | MA | Primary |
| Social Worker | 104100000X | 337825 | MA |
Addresses
Primary practice location
85 Constitution LN
Danvers, MA 01923-3694
Mailing address
85 Constitution LN
Danvers, MA 01923-3694
Phone (978) 991-1978
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
| License | State | Type | Specialty |
|---|---|---|---|
| 337825 | MA | MD | Social Worker |
| 23607 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733875200000",
"number": "1790592061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 CONSTITUTION LN",
"city": "DANVERS",
"state": "MA",
"postal_code": "019233694",
"telephone_number": "978-991-1978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 CONSTITUTION LN",
"city": "DANVERS",
"state": "MA",
"postal_code": "019233694",
"telephone_number": "617-320-9058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDIN",
"first_name": "SHANNON",
"middle_name": "M",
"credential": "LADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-11",
"last_updated": "2024-12-11",
"certification_date": "2024-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MA",
"license": "23607",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "337825",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danvers, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.