Provider Demographics
NPI:1568651453
Name:LUDWIG, NANCY ANN (LCSW/LADC/CCS)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:LCSW/LADC/CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PARK ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7172
Mailing Address - Country:US
Mailing Address - Phone:207-784-0922
Mailing Address - Fax:207-784-6143
Practice Address - Street 1:4 PARK ST
Practice Address - Street 2:SUITE 1
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7172
Practice Address - Country:US
Practice Address - Phone:207-784-0922
Practice Address - Fax:207-784-6143
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC782101YA0400X
MELC33601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM357580Medicare PIN