Individual provider Active NPI

Jon Lundquist, L.C.S.W.

  • Clinical Social Worker
  • Russellville, AR
National Provider Identifier
1962481010
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-417 Issued in AR
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, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
C-417ARMDClinical 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.

Verify at the official NPI Registry.