Provider Demographics
NPI:1679859698
Name:LUNDBERG, JOANN (MA, LPC, ATR-BC)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:LUNDBERG
Suffix:
Gender:F
Credentials:MA, LPC, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor