Provider Demographics
NPI:1033845631
Name:JOANN LUNDBERG LPC PC
Entity Type:Organization
Organization Name:JOANN LUNDBERG LPC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:503-720-9545
Mailing Address - Street 1:11997 SE HUNTER DR
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-6719
Mailing Address - Country:US
Mailing Address - Phone:503-720-9545
Mailing Address - Fax:
Practice Address - Street 1:11997 SE HUNTER DR
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-6719
Practice Address - Country:US
Practice Address - Phone:503-720-9545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty