Active NPI
Kristen Suzanne Rudolf
- Mental Health Counselor
- Eugene, OR
National Provider Identifier
1760937692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C7820
- Practice address
- 115 W 8TH Ave Ste 300
Eugene, OR 97401-2997 - Phone
- (541) 243-7544
- NPI assigned
- Aug 21, 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C7820 | OR | Primary |
Addresses
Primary practice location
115 W 8TH Ave Ste 300
Eugene, OR 97401-2997
Mailing address
PO Box 1530
Waldport, OR 97394-1530
Phone (650) 468-0003
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 11, 2025 through Nov 11, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C7820 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706572800000",
"number": "1760937692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1530",
"city": "WALDPORT",
"state": "OR",
"postal_code": "973941530",
"telephone_number": "650-468-0003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 W 8TH AVE STE 300",
"city": "EUGENE",
"state": "OR",
"postal_code": "974012997",
"telephone_number": "541-243-7544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDOLF",
"first_name": "KRISTEN",
"middle_name": "SUZANNE",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-21",
"last_updated": "2024-01-30",
"certification_date": "2024-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C7820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.