Provider Demographics
NPI:1760619514
Name:M.W. LADWIG, L.M.H.C., INC.
Entity Type:Organization
Organization Name:M.W. LADWIG, L.M.H.C., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:LADWIG
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:386-506-9381
Mailing Address - Street 1:595 W. GRANADA BLVD.
Mailing Address - Street 2:SUITE E-2 (E. COAST NEUROPSYCHIATRIC)
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174
Mailing Address - Country:US
Mailing Address - Phone:386-672-4222
Mailing Address - Fax:386-672-8855
Practice Address - Street 1:595 W. GRANADA BLVD.
Practice Address - Street 2:SUITE E-2 (E. COAST NEUROPSYCHIATRIC)
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174
Practice Address - Country:US
Practice Address - Phone:386-672-4222
Practice Address - Fax:386-672-8855
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:M.W. LADWIG, L.M.H.C. INC.,
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH#00874101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty