Provider Demographics
NPI:1326728411
Name:LUDWIGSEN WELLNESS ASSOCIATES LLC
Entity Type:Organization
Organization Name:LUDWIGSEN WELLNESS ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LUDWIGSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, CST, LCSW
Authorized Official - Phone:856-448-4352
Mailing Address - Street 1:19 CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3916
Mailing Address - Country:US
Mailing Address - Phone:856-448-4352
Mailing Address - Fax:
Practice Address - Street 1:19 CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-3916
Practice Address - Country:US
Practice Address - Phone:856-448-4352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health