Provider Demographics
NPI:1376354068
Name:ESONG, LEDWINE
Entity type:Individual
Prefix:
First Name:LEDWINE
Middle Name:
Last Name:ESONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3933 WARNER AVE
Mailing Address - Street 2:
Mailing Address - City:LANDOVER HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20784-2066
Mailing Address - Country:US
Mailing Address - Phone:240-764-9358
Mailing Address - Fax:
Practice Address - Street 1:3933 WARNER AVE
Practice Address - Street 2:
Practice Address - City:LANDOVER HILLS
Practice Address - State:MD
Practice Address - Zip Code:20784-2066
Practice Address - Country:US
Practice Address - Phone:240-764-9358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator