Active NPI
Jon Lundquist, L.C.S.W.
- Clinical Social Worker
- Russellville, AR
National Provider Identifier
1962481010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C-417
- Practice address
- 127 E 2ND St
Suite B
Russellville, AR 72801-5143 - Phone
- (479) 968-3605
- Fax
- (479) 890-3446
- NPI assigned
- Jan 16, 2006
- Last updated
- Jul 13, 2026
- 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 | C-417 | AR | Primary |
Addresses
Primary practice location
127 E 2ND St
Suite B
Russellville, AR 72801-5143
Mailing address
127 E 2ND St
Suite B
Russellville, AR 72801-5143
Phone (479) 968-3605
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-417 | AR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1962481010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 E 2ND ST",
"address_2": "SUITE B",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "728015143",
"telephone_number": "479-968-3605",
"fax_number": "479-890-3446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 E 2ND ST",
"address_2": "SUITE B",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "728015143",
"telephone_number": "479-968-3605",
"fax_number": "479-890-3446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDQUIST",
"first_name": "JON",
"name_prefix": "Mr.",
"credential": "L.C.S.W.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-16",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AR",
"license": "C-417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Russellville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.