Provider Demographics
NPI:1134156094
Name:LUDVIK, CHERYL LYNNE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:LYNNE
Last Name:LUDVIK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 GREENBRIER PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2876
Mailing Address - Country:US
Mailing Address - Phone:757-312-8002
Mailing Address - Fax:757-547-4584
Practice Address - Street 1:1403 GREENBRIER PKWY STE 200
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2876
Practice Address - Country:US
Practice Address - Phone:757-436-2444
Practice Address - Fax:757-547-4584
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040022971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA80000282636633Medicaid
VA80000282636633Medicaid
VAP39469Medicare UPIN