Organization Active NPI

Lunden Psychological Services, Inc.

  • Psychologist
  • Seminole, FL
National Provider Identifier
1912393349
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY9206 Issued in FL
Legal business name
LUNDEN PSYCHOLOGICAL SERVICES, INC.
Practice address
9160 Oakhurst Rd
Suite 3B
Seminole, FL 33776-2157
Phone
(727) 240-1922
Fax
(727) 240-1928
NPI assigned
Apr 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Authorized official

Name
Judy Carol Lunden, PSY.D.NPI 1174913461
Title
President/Psychologist
Phone
(727) 240-1922

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PY9206 FL Primary

Addresses

Primary practice location

9160 Oakhurst Rd
Suite 3B
Seminole, FL 33776-2157

Mailing address

9160 Oakhurst Rd
Suite 3B
Seminole, FL 33776-2157
Phone (727) 240-1922

Other identifiers 1

IdentifierTypeStateIssuer
014703800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151016000011 FL Part B Supplier - Clinic/Group Practice 4587973425 Receives reassigned benefits from 1 practitioner
Practice locations: Seminole, FL

National Provider Directory

National Provider Directory

Locations

9160 Oakhurst Rd
Ste 3B
Seminole, FL 33776
Phone (727) 240-1922

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1912393349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9160 OAKHURST RD",
            "address_2": "SUITE 3B",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337762157",
            "telephone_number": "727-240-1922",
            "fax_number": "727-240-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9160 OAKHURST RD",
            "address_2": "SUITE 3B",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337762157",
            "telephone_number": "727-240-1922",
            "fax_number": "727-240-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNDEN PSYCHOLOGICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-13",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "LUNDEN",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "PRESIDENT/PSYCHOLOGIST",
        "authorized_official_telephone_number": "727-240-1922",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY9206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014703800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seminole, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.