Provider Demographics
NPI:1578632220
Name:LUDWIG, KIRSTEN ANN (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:KIRSTEN
Middle Name:ANN
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 1:1111 PAINE ST
Mailing Address - Street 2:
Mailing Address - City:DECORAH
Mailing Address - State:IA
Mailing Address - Zip Code:52101
Mailing Address - Country:US
Mailing Address - Phone:563-382-1900
Mailing Address - Fax:563-382-1777
Practice Address - Street 1:1111 PAINE ST
Practice Address - Street 2:
Practice Address - City:DECORAH
Practice Address - State:IA
Practice Address - Zip Code:52101
Practice Address - Country:US
Practice Address - Phone:563-382-1900
Practice Address - Fax:563-382-1777
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00797101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health