Provider Demographics
NPI:1508069246
Name:LUDLOW, WENDY ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:ELIZABETH
Last Name:LUDLOW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 CAMINO DON EMILIO
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-7654
Mailing Address - Country:US
Mailing Address - Phone:646-408-7436
Mailing Address - Fax:
Practice Address - Street 1:SOUTHWEST FAMILY GUIDANCE CTR
Practice Address - Street 2:4001 OFFICE CT.
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507
Practice Address - Country:US
Practice Address - Phone:646-408-7436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR053537-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical