Provider Demographics
NPI:1568719607
Name:LUDWIG, KEVIN (BS)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:
Last Name:LUDWIG
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-7042
Mailing Address - Country:US
Mailing Address - Phone:515-290-2424
Mailing Address - Fax:
Practice Address - Street 1:125 S 3RD ST
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-7042
Practice Address - Country:US
Practice Address - Phone:515-290-2424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA14002101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)