Provider Demographics
NPI:1720230279
Name:LUDWIG, LINDA RAE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:RAE
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-2724
Mailing Address - Country:US
Mailing Address - Phone:914-238-7906
Mailing Address - Fax:
Practice Address - Street 1:250 BEDFORD RD
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514-2724
Practice Address - Country:US
Practice Address - Phone:914-238-7906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYMHC000404-1101YM0800X
CAMFT21626106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist