1. Home
  2. Directory
  3. California
  4. San Luis Obispo
  5. Marriage Family Therapist
  6. NPI Profile

MS. KRISTEN VIRGINIA ROUDEBUSH LMFT
NPI 1124369244
Marriage & Family Therapist in San Luis Obispo, CA

Active since March 14, 2013PECOS Enrolled
2050 BROAD ST, SAN LUIS OBISPO, CA 93401(805) 441-3845 Get Directions Write a Review

NPPES record last updated: July 30, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Ms. Kristen Virginia Roudebush Lmft NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. KRISTEN VIRGINIA ROUDEBUSH LMFT (NPI 1124369244) is an individual marriage & family therapist in San Luis Obispo, California, licensed in California (107108) and active in the NPI registry since March 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124369244
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameMS. KRISTEN VIRGINIA ROUDEBUSHCredential: LMFT
Location Address2050 BROAD STSan Luis Obispo, CA 93401
Mailing Address2050 Broad StSan Luis Obispo, CA 93401-5203 · (805) 441-3845
Phone(805) 441-3845
Sole ProprietorYes
Enumeration DateMarch 14, 2013
Last NPPES UpdateJuly 30, 2018
✔ NPI 1124369244 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · 107108
Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

2050 BROAD ST, San Luis Obispo, CA 93401
Open in Google Maps ↗

Other Names 1

Professional Name (2)Kris Roudebush Lmft

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ms. Kristen Virginia Roudebush Lmft has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2026.

Opt-Out Effective DateJanuary 1, 2024
Opt-Out In Effect ThroughJanuary 1, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Frequently Asked Questions

What is Kristen Roudebush's NPI number?

The NPI number assigned to this healthcare provider is 1124369244, enumerated as an "individual" on March 14, 2013.

Where is the provider located?

The provider is located at 2050 BROAD ST SAN LUIS OBISPO, CA 93401 and the phone number is (805) 441-3845.

What is the provider's specialty?

Marriage & Family Therapist with taxonomy code 106H00000X.