Provider Demographics
NPI:1669459202
Name:STEVENS, LUDMILLA V (MSW,LCSW,PIP)
Entity Type:Individual
Prefix:MS
First Name:LUDMILLA
Middle Name:V
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MSW,LCSW,PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 152
Mailing Address - Street 2:
Mailing Address - City:HANCEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35077-0152
Mailing Address - Country:US
Mailing Address - Phone:256-736-3408
Mailing Address - Fax:256-736-1077
Practice Address - Street 1:502 3RD ST SE
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-3627
Practice Address - Country:US
Practice Address - Phone:256-736-3408
Practice Address - Fax:256-736-1077
Is Sole Proprietor?:No
Enumeration Date:2005-12-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0646-1726C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALP67907Medicare UPIN