Healthcare Provider Details
I. General information
NPI: 1295860104
Provider Name (Legal Business Name): DEBRA LYNN LUND MA,CAGS ,LMHC, LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/22/2007
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
683 OLD CASTLE DR
RANDLEMAN NC
27317-8312
US
IV. Provider business mailing address
683 OLD CASTLE DR
RANDLEMAN NC
27317-8312
US
V. Phone/Fax
- Phone: 603-562-8516
- Fax:
- Phone: 603-562-8516
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 17573 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 5845 |
| License Number State | MA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: