Provider Demographics
NPI:1265656029
Name:LUND, STEPHANIE MARIE (LPC-MH)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:MARIE
Last Name:LUND
Suffix:
Gender:F
Credentials:LPC-MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 672
Mailing Address - Street 2:
Mailing Address - City:POLLOCK
Mailing Address - State:SD
Mailing Address - Zip Code:57648-0672
Mailing Address - Country:US
Mailing Address - Phone:605-848-4957
Mailing Address - Fax:833-266-6765
Practice Address - Street 1:318 OAHE ST
Practice Address - Street 2:
Practice Address - City:POLLOCK
Practice Address - State:SD
Practice Address - Zip Code:57648-2403
Practice Address - Country:US
Practice Address - Phone:605-848-4957
Practice Address - Fax:833-266-6765
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
SDLPCMH20271101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health