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NPI Code Detail

MEDICARE: LYUDMILA KISINA LMFT, LAADC

MEDICARE: LYUDMILA KISINA LMFT, LAADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist002689NY
2106H00000XMarriage & Family Therapist144514CA
3101YA0400XAddiction (Substance Use Disorder) CounselorLR10280523CA

General Provider Information

NPI Number : 1710307400
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYUDMILA KISINA LMFT, LAADC
Provider Business Mailing Address
First Line : 302 E 94TH ST APT 1A
Second Line :
City : NEW YORK
State : NY
Zip : 10128-5622
Country : US
Telephone Number : 619-233-3432
Fax Number : 619-233-7022
Provider Business Practice Location Address
First Line : 680 E COLORADO BLVD STE 180
Second Line :
City : PASADENA
State : CA
Zip : 91101-6144
Country : US
Telephone Number : 646-941-7645
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2014
Last Update Date : 01/09/2026

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