Active NPI
Lisa Christine Lundgren, LADC/MH #956
- Addiction (Substance Use Disorder) Counselor
- Ada, OK
National Provider Identifier
1801013651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 956
- Practice address
- 3115 E. Arlington Blvd.
Healthy Lifestyles
Ada, OK 74820 - Phone
- (580) 332-6345
- Fax
- (580) 421-7724
- NPI assigned
- Apr 20, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Mental Health Counselor | 101YM0800X | 956 | OK | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 956 | OK | Primary |
Addresses
Primary practice location
3115 E. Arlington Blvd.
Healthy Lifestyles
Ada, OK 74820
Mailing address
Resource Management
1300 Hoppe Blvd., Suite 1
Ada, OK 74820
Phone (580) 436-7211
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 |
|---|---|---|---|
| 956 | OK | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chickasaw Nation - Family Services | Past | Accepting new patients |
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.
-
- Professional Counselor
- Ada, OK
- NPI 1588968275
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537315200000",
"number": "1801013651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RESOURCE MANAGEMENT",
"address_2": "1300 HOPPE BLVD., SUITE 1",
"city": "ADA",
"state": "OK",
"postal_code": "74820",
"telephone_number": "580-436-7211",
"fax_number": "580-272-5757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3115 E. ARLINGTON BLVD.",
"address_2": "HEALTHY LIFESTYLES",
"city": "ADA",
"state": "OK",
"postal_code": "74820",
"telephone_number": "580-332-6345",
"fax_number": "580-421-7724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDGREN",
"first_name": "LISA",
"middle_name": "CHRISTINE",
"credential": "LADC/MH #956",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-20",
"last_updated": "2018-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OK",
"license": "956",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OK",
"license": "956",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ada, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.