Provider Demographics
NPI:1477910586
Name:DR. AMALIA HUMADA-LUDEKE, LMFT
Entity Type:Organization
Organization Name:DR. AMALIA HUMADA-LUDEKE, LMFT
Other - Org Name:MARRIAGE & FAMILY THERAPY PRACTICE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMADA-LUDEKE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:505-231-9156
Mailing Address - Street 1:PO BOX 5040
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88062-5040
Mailing Address - Country:US
Mailing Address - Phone:575-956-6135
Mailing Address - Fax:575-956-6204
Practice Address - Street 1:530 HIGHWAY 180 W
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-4400
Practice Address - Country:US
Practice Address - Phone:505-231-9156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0177351106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty