Active NPI
Luci A Ladue, CADC II/QMHP-R
- Addiction (Substance Use Disorder) Counselor
- Gresham, OR
National Provider Identifier
1194046110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 11-R-12
- Practice address
- 620 NE 2ND St
Gresham, OR 97030-7514 - Phone
- (971) 274-3757
- Fax
- (503) 912-5740
- NPI assigned
- Jun 14, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 24-QMHP-R-3281 | OR | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 11-R-12 | OR | Primary |
Addresses
Primary practice location
620 NE 2ND St
Gresham, OR 97030-7514
Mailing address
211 SE Caruthers St
Portland, OR 97214-4502
Phone (503) 224-1044
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500641189 | Medicaid | OR | |
| 500777183 | Medicaid | OR |
Other names 1
- Luci A Ludlow
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11-R-12 | OR | MD | Addiction (Substance Use Disorder) Counselor |
| 24-QMHP-R-3281 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735257600000",
"number": "1194046110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 SE CARUTHERS ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972144502",
"telephone_number": "503-224-1044",
"fax_number": "971-260-0355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 NE 2ND ST",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970307514",
"telephone_number": "971-274-3757",
"fax_number": "503-912-5740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LADUE",
"first_name": "LUCI",
"middle_name": "A",
"credential": "CADC II/QMHP-R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-14",
"last_updated": "2024-12-27",
"certification_date": "2024-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "24-QMHP-R-3281",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "11-R-12",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500641189",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500777183",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LUCI",
"last_name": "LUDLOW",
"middle_name": "A",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.