Provider Demographics
NPI:1508194044
Name:LUDWIG, RENAE LOUISE (LMHC)
Entity Type:Individual
Prefix:
First Name:RENAE
Middle Name:LOUISE
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 79TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8009
Mailing Address - Country:US
Mailing Address - Phone:612-730-4401
Mailing Address - Fax:
Practice Address - Street 1:2670 106TH ST STE 101
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-3746
Practice Address - Country:US
Practice Address - Phone:612-730-4401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00009101YM0800X
IA00110101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health