Provider Demographics
NPI:1154743326
Name:LETZRING, KYRA MICHELLE (LPC, CADCIII)
Entity type:Individual
Prefix:
First Name:KYRA
Middle Name:MICHELLE
Last Name:LETZRING
Suffix:
Gender:F
Credentials:LPC, CADCIII
Other - Prefix:
Other - First Name:KYRA
Other - Middle Name:MICHELLE
Other - Last Name:BIVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CADCI
Mailing Address - Street 1:422 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-6048
Mailing Address - Country:US
Mailing Address - Phone:541-851-3300
Mailing Address - Fax:541-363-5678
Practice Address - Street 1:422 MAIN ST
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-6048
Practice Address - Country:US
Practice Address - Phone:541-851-3300
Practice Address - Fax:541-363-5678
Is Sole Proprietor?:No
Enumeration Date:2014-01-07
Last Update Date:2023-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1114058898Medicaid
OR1720105489Medicaid
OR930386860OtherLUTHERAN COMMUNITY SERVICES NW