1750446597 NPI number — MR. STEPHEN EDWARD LUNDRIGAN MA LMHC

Table of content: MR. STEPHEN EDWARD LUNDRIGAN MA LMHC (NPI 1750446597)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750446597 NPI number — MR. STEPHEN EDWARD LUNDRIGAN MA LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LUNDRIGAN
Provider First Name:
STEPHEN
Provider Middle Name:
EDWARD
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MA LMHC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750446597
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/28/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 RICHARDS AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PAXTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01612-1120
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-527-1120
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
74 ELM ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WORCESTER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01609-2362
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-527-1120
Provider Business Practice Location Address Fax Number:
866-450-3056
Provider Enumeration Date:
12/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  3846 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 243856 . This is a "MHN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 460362 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 350198000 IP5684 . This is a "MAGELLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 7994365 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: A023693 MHS013502 . This is a "VALUE OPTIONS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2044427 . This is a "HCVM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2071939 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1895141 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: LM0854 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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