Lupine Family Services, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

LUPINE FAMILY SERVICES, LLC

Practice address

43335 Kalifornski Beach Rd BLDG G
Soldotna, AK 99669-8280

Phone

(907) 250-1304

Fax

(949) 863-5157

NPI assigned

Oct 13, 2021

Organization subpart

No

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

Authorized official

Name

Colleen Shawna Nusbaum, LCSWNPI 1295996858

Title

Director

Phone

(907) 394-4442

Specialties & licenses 7

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Colleen Nusbaum, LCSW, CDCI

  • Clinical Social Worker
  • Soldotna, AK
  • NPI 1295996858
  NPD Authorized official

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1861154262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 AMES RD UNIT 2",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996118333",
            "telephone_number": "907-394-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43335 KALIFORNSKI BEACH RD BLDG G",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996698280",
            "telephone_number": "907-250-1304",
            "fax_number": "949-863-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUPINE FAMILY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "NUSBAUM",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "SHAWNA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "907-394-4442",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@lupinefs.directak.net",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging through Health Connect Alaska.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Messaging through Health Connect Alaska.",
            "address_1": "43335 Kalifornski Beach Road Bldg. D",
            "address_2": "Ste 16D",
            "city": "Soldotna",
            "state": "AK",
            "country_code": "US",
            "postal_code": "99669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jodi Lynn Lout, CDC1
• Chelsea Ludlow, OTR/L
• Mary Lukens
• Harry Luna
• Gabrielle Lundeberg, LMT
• Timothy Lybrand
• Savannah Jeane Lyons, SPT
• Rita Ann Lyseng, CRNA
• Kay Lytle
• Sven K Maakestad

• Clinical Social Worker in Soldotna, AK
• Providers in Soldotna, AK by specialty
• Clinical Social Worker in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.