Provider Demographics
NPI:1396158564
Name:ASZOD, LUDWIG JAMES (LPC)
Entity type:Individual
Prefix:
First Name:LUDWIG
Middle Name:JAMES
Last Name:ASZOD
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3012 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72830-8007
Mailing Address - Country:US
Mailing Address - Phone:479-774-2131
Mailing Address - Fax:
Practice Address - Street 1:910 S ROGERS ST
Practice Address - Street 2:STE C
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-4331
Practice Address - Country:US
Practice Address - Phone:479-774-2131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1410082101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR228090719Medicaid