Elizabeth Marie Lundberg, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

DP00944732 Issued in WV

Practice address

103 Marcley Dr
Martinsburg, WV 25401-2977

Phone

(304) 263-0964

NPI assigned

Jun 29, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: elizabeth.lungberg.p1@direct.familyhch.nextgenshare.com

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1912428061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 MARCLEY DR",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012977",
            "telephone_number": "304-263-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MARCLEY DR",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012977",
            "telephone_number": "304-263-0964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "613 Winchester Ave",
            "address_purpose": "LOCATION",
            "city": "Martinsburg",
            "state": "WV",
            "postal_code": "254012101",
            "country_code": "US",
            "telephone_number": "304-596-5508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUNDBERG",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904014127",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00944732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloria Roseanna Loy
• Mary Lozano
• Heidi Lynn Lucas, LPC
• Tanner Lee Lucas
• Ty Lucas
• Jessica Lundblad
• Annie Marie Lung
• Jenna Marie Lupinetti, LPC
• Doris Luthi
• Brittany Lutz-Hoffman

• Clinical Social Worker in Martinsburg, WV
• Providers in Martinsburg, WV by specialty
• Clinical Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; 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.