Active NPI
Shiloh Lundahl, LCSW
- Clinical Social Worker
- Mesa, AZ
National Provider Identifier
1891013777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-13355
- Practice address
- 6402 E Superstition Springs Blvd
Suite 208
Mesa, AZ 85206-4392 - Phone
- (480) 668-8301
- Fax
- (480) 558-3020
- NPI assigned
- May 17, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-13355 | AZ | Primary |
Addresses
Primary practice location
6402 E Superstition Springs Blvd
Suite 208
Mesa, AZ 85206-4392
Mailing address
3048 E Baseline Rd. Ste 108
Mesa, AZ 85204
Phone (602) 492-5055
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 |
|---|---|---|---|
| LCSW-13355 | AZ | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Strategies LLC | 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
- Mesa, AZ
- NPI 1811330210
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434672000000",
"number": "1891013777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3048 E BASELINE RD. STE 108",
"city": "MESA",
"state": "AZ",
"postal_code": "85204",
"telephone_number": "602-492-5055",
"fax_number": "480-558-3020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6402 E SUPERSTITION SPRINGS BLVD",
"address_2": "SUITE 208",
"city": "MESA",
"state": "AZ",
"postal_code": "852064392",
"telephone_number": "480-668-8301",
"fax_number": "480-558-3020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDAHL",
"first_name": "SHILOH",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-17",
"last_updated": "2015-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "LCSW-13355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.