Provider Demographics
NPI:1457866345
Name:LUDWIG, JENNIFER R (LMFT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1193 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3521
Mailing Address - Country:US
Mailing Address - Phone:541-321-0673
Mailing Address - Fax:541-343-7360
Practice Address - Street 1:1193 PEARL ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3521
Practice Address - Country:US
Practice Address - Phone:541-313-3468
Practice Address - Fax:541-325-4042
Is Sole Proprietor?:No
Enumeration Date:2017-12-13
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORT2112106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health