Provider Demographics
NPI:1750446597
Name:LUNDRIGAN, STEPHEN EDWARD (MA LMHC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:EDWARD
Last Name:LUNDRIGAN
Suffix:
Gender:M
Credentials:MA LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 NICHOLS ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-4011
Mailing Address - Country:US
Mailing Address - Phone:508-527-1120
Mailing Address - Fax:
Practice Address - Street 1:135 NICHOLS ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-4011
Practice Address - Country:US
Practice Address - Phone:508-527-1120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3846101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA243856OtherMHN
MA460362OtherTUFTS
MA350198000 IP5684OtherMAGELLAN
MA7994365OtherAETNA
MAA023693 MHS013502OtherVALUE OPTIONS
MA2044427OtherHCVM
MA2071939OtherCIGNA
MA1895141Medicaid
MALM0854OtherBLUE CROSS BLUE SHIELD