Provider Demographics
NPI:1114782109
Name:LUDLOW, SHERYL ANN (LMSW)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:ANN
Last Name:LUDLOW
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 S EASTMOOR ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-3227
Mailing Address - Country:US
Mailing Address - Phone:316-519-7574
Mailing Address - Fax:
Practice Address - Street 1:7101 E 21ST ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-1044
Practice Address - Country:US
Practice Address - Phone:316-258-1661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2173101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health