Provider Demographics
NPI:1588373476
Name:LUND, JAMIE DAWN (LMSW)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:DAWN
Last Name:LUND
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:DAWN
Other - Last Name:TYSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW, LBSW
Mailing Address - Street 1:219 7TH ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-1819
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:219 7TH ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-1819
Practice Address - Country:US
Practice Address - Phone:701-429-4365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator