Provider Demographics
NPI:1194028720
Name:MIKA-LUDE, KARI MARIE (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:KARI
Middle Name:MARIE
Last Name:MIKA-LUDE
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:MISS
Other - First Name:KARI
Other - Middle Name:MARIE
Other - Last Name:MIKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 172
Mailing Address - Street 2:
Mailing Address - City:CULLODEN
Mailing Address - State:WV
Mailing Address - Zip Code:25510-0172
Mailing Address - Country:US
Mailing Address - Phone:304-760-9945
Mailing Address - Fax:
Practice Address - Street 1:3847 TEAYS VALLEY RD
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9820
Practice Address - Country:US
Practice Address - Phone:304-760-9945
Practice Address - Fax:304-397-0896
Is Sole Proprietor?:No
Enumeration Date:2010-12-21
Last Update Date:2023-08-29
Deactivation Date:2013-07-15
Deactivation Code:
Reactivation Date:2013-11-15
Provider Licenses
StateLicense IDTaxonomies
WV16-323101YA0400X
IL178.008859101YP2500X
WV2276101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)