Provider Demographics
NPI:1760013106
Name:LUEDDE, JODY (LPC)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:
Last Name:LUEDDE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MASON ST
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-4450
Mailing Address - Country:US
Mailing Address - Phone:281-255-9922
Mailing Address - Fax:281-255-9064
Practice Address - Street 1:500 MASON ST
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-4450
Practice Address - Country:US
Practice Address - Phone:281-255-9922
Practice Address - Fax:281-255-9064
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78172101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional