Active NPI
Erynn Kuderik, LPC
- Professional Counselor
- Toledo, OH
National Provider Identifier
1467805192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C 1400510
- Practice address
- 424 W Woodruff Ave
Toledo, OH 43604-5027 - Phone
- (419) 841-7701
- NPI assigned
- Jul 18, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C 1400510 | OH | Primary |
Addresses
Primary practice location
424 W Woodruff Ave
Toledo, OH 43604-5027
Mailing address
2005 Ashland Ave
Toledo, OH 43620-1703
Phone (419) 841-7701
Other practice location 1
123 22nd St
Toledo, OH 43604
Phone (419) 241-6191
Other names 1
- Erynn Daum
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 |
|---|---|---|---|
| C 1400510 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602720000000",
"number": "1467805192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2005 ASHLAND AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436201703",
"telephone_number": "419-841-7701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 W WOODRUFF AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436045027",
"telephone_number": "419-841-7701"
}
],
"practiceLocations": [
{
"address_1": "123 22nd St",
"address_purpose": "LOCATION",
"city": "Toledo",
"state": "OH",
"postal_code": "43604",
"country_code": "US",
"telephone_number": "419-241-6191",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KUDERIK",
"first_name": "ERYNN",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-18",
"last_updated": "2020-10-15",
"certification_date": "2020-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "C 1400510",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ERYNN",
"last_name": "DAUM",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.