Provider Demographics
NPI:1619964954
Name:LUDWIG, BECKY LYNN (LSW)
Entity Type:Individual
Prefix:MRS
First Name:BECKY
Middle Name:LYNN
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MS
Other - First Name:BECKY
Other - Middle Name:LYNN
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW, CCDP, CCJP
Mailing Address - Street 1:102 COUNTRYVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:MCKEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136
Mailing Address - Country:US
Mailing Address - Phone:412-979-4957
Mailing Address - Fax:
Practice Address - Street 1:81 S 19TH ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-1852
Practice Address - Country:US
Practice Address - Phone:412-431-5665
Practice Address - Fax:412-431-0913
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW123141104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
1427992OtherHIGHMARK