Provider Demographics
NPI:1477724680
Name:LUNDE, THEODORE E (LPC)
Entity Type:Individual
Prefix:
First Name:THEODORE
Middle Name:E
Last Name:LUNDE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8941 JIMSON WEED WAY
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-2641
Mailing Address - Country:US
Mailing Address - Phone:303-759-1060
Mailing Address - Fax:
Practice Address - Street 1:8941 JIMSON WEED WAY
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-2641
Practice Address - Country:US
Practice Address - Phone:303-759-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2788101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional