Provider Demographics
NPI:1740577410
Name:LUEDTKE, LINDSEY KRISTINE (PSYD)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:KRISTINE
Last Name:LUEDTKE
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 1:7424 BROCK RD
Mailing Address - Street 2:PO BOX 277
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22553-2002
Mailing Address - Country:US
Mailing Address - Phone:540-582-3980
Mailing Address - Fax:540-582-6825
Practice Address - Street 1:7427 BROCK ROAD
Practice Address - Street 2:
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22553-1764
Practice Address - Country:US
Practice Address - Phone:540-582-3980
Practice Address - Fax:540-582-6825
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004416103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical