Provider Demographics
NPI:1023375763
Name:HOWARD, LUDLEY (MSW)
Entity Type:Individual
Prefix:
First Name:LUDLEY
Middle Name:
Last Name:HOWARD
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10760 HICKORY RIDGE RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3682
Mailing Address - Country:US
Mailing Address - Phone:410-740-7397
Mailing Address - Fax:410-740-7398
Practice Address - Street 1:10760 HICKORY RIDGE RD
Practice Address - Street 2:SUITE 211
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3682
Practice Address - Country:US
Practice Address - Phone:410-740-7397
Practice Address - Fax:410-740-7398
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD253401100Medicaid