Shelly Lund Psychotherapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2774-123 Issued in WI

Legal business name

SHELLY LUND PSYCHOTHERAPY LLC

Practice address

400 Genesee St FL 3
Delafield, WI 53018-1867

Phone

(262) 370-2778

NPI assigned

Jul 17, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Shelly Lund, LCSW

Title

Clinical Social Worker/Counselor

Phone

(262) 370-2778

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531785600000",
    "number": "1922584515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 BARK RIVER DR.",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "53029",
            "telephone_number": "262-370-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 GENESEE ST FL 3",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530181867",
            "telephone_number": "262-370-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELLY LUND PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-07-17",
        "status": "A",
        "authorized_official_last_name": "LUND",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER/COUNSELOR",
        "authorized_official_telephone_number": "262-370-2778",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "2774-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Delafield, WI
• Providers in Delafield, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.

Verify at the official NPI Registry.