Individual provider Active NPI

Karen J Dudley, LMFT

  • Marriage & Family Therapist
  • Lynchburg, VA
National Provider Identifier
1790886190
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
0717001108 Issued in VA
Practice address
2215 Langhorne Rd
Suite 104
Lynchburg, VA 24501-1121
Phone
(434) 455-3047
Fax
(434) 948-4918
NPI assigned
Sep 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0717001108 VA Primary

Addresses

Primary practice location

2215 Langhorne Rd
Suite 104
Lynchburg, VA 24501-1121

Mailing address

2215 Langhorne Rd
Suite 104
Lynchburg, VA 24501-1121
Phone (434) 455-3047

Other identifiers 1

IdentifierTypeStateIssuer
248359OtherVAANTHEM BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241014004103 VA Practitioner - Mental Health Counselor 3274065362 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0717001108VAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wyndhurst Counseling Center, LLC CurrentSince Sep 17, 2024 Accepting new patients
Taylored Counseling Services LLC PastSince Sep 17, 2024 Accepting new patients

Locations

371 Oakdale Cir
Lynchburg, VA 24502
Phone (434) 237-2655

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790886190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 LANGHORNE RD",
            "address_2": "SUITE 104",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011121",
            "telephone_number": "434-455-3047",
            "fax_number": "434-948-4918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 LANGHORNE RD",
            "address_2": "SUITE 104",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011121",
            "telephone_number": "434-455-3047",
            "fax_number": "434-948-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "KAREN",
        "middle_name": "J",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717001108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE SHIELD",
            "identifier": "248359",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.