Provider Demographics
NPI:1164551370
Name:BUDDE, DAVID LEE (LPC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LEE
Last Name:BUDDE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 SHERWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-2021
Mailing Address - Country:US
Mailing Address - Phone:989-327-1080
Mailing Address - Fax:
Practice Address - Street 1:3190 HALLMARK CT
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-2190
Practice Address - Country:US
Practice Address - Phone:989-790-3366
Practice Address - Fax:989-790-5027
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801020512104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN80300020Medicare PIN