Kyla Marie Ludington

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

3734 NE Petrosa Ave
Bend, OR 97701-3995

Phone

(206) 595-7068

NPI assigned

Jun 5, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Kyla Marie Keller Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1689103566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3734 NE PETROSA AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013995",
            "telephone_number": "206-595-7068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3734 NE PETROSA AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013995",
            "telephone_number": "206-595-7068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDINGTON",
        "first_name": "KYLA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60553320",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLA",
            "last_name": "KELLER",
            "middle_name": "MARIE",
            "credential": "LMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lucas Home Care, LLC
• Jenine Lucas
• Taylor Lucas
• Justine R Lucia, LMT
• Ericka C Luckel, P.A.
• Ashley Marie Ludwig, B.A.
• Lori Kae Ludwig
• Aurora Maria Luebbe, QMHA - I
• Katherine Manni Lui, LAC
• Nelly Lukale

• Marriage & Family Therapist in Bend, OR
• Providers in Bend, OR by specialty
• Marriage & Family Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.

Verify at the official NPI Registry.