Individual provider Active NPI

Ludmilla Zuckman, LPC

  • Professional Counselor
  • Portland, OR
National Provider Identifier
1851644231
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C3980 Issued in OR
Practice address
605 SE Cesar E Chavez Blvd
Portland, OR 97214-3216
Phone
(503) 231-7480
NPI assigned
Oct 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C3980 OR
Professional Counselor 101YP2500X C3980 OR Primary

Addresses

Primary practice location

605 SE Cesar E Chavez Blvd
Portland, OR 97214-3216

Mailing address

605 SE Cesar E Chavez Blvd
Portland, OR 97214-3216
Phone (503) 231-7480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20241219003053 OR Practitioner - Mental Health Counselor 5597292250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lutheran Community Services NorthwestGroup PAC ID 1254237522, 13 clinicians

Practice addresses (Care Compare)

605 SE Cesar E Chavez Blvd
Portland, OR 97214-3216
Phone (503) 231-7480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C3980ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Community Services Northwest CurrentSince Oct 17, 2024 Accepting new patients
Lutheran Community Services Northwest CurrentSince Oct 17, 2024 Accepting new patients
Luda Counseling Mental Health Current Accepting new patients

Locations

605 SE Cesar E Chavez Blvd
Portland, OR 97214
Phone (503) 731-9539

4040 S 188th St
Ste 300
Seatac, WA 98188
Phone (206) 816-3253

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1851644231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 SE CESAR E CHAVEZ BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143216",
            "telephone_number": "503-231-7480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 SE CESAR E CHAVEZ BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143216",
            "telephone_number": "503-231-7480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUCKMAN",
        "first_name": "LUDMILLA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-22",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C3980",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.