Provider Demographics
NPI:1831915222
Name:DR. LUCINDA WOODWARD, LLC
Entity type:Organization
Organization Name:DR. LUCINDA WOODWARD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODWARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:812-844-3918
Mailing Address - Street 1:3358 W VINCENNES TRL
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:IN
Mailing Address - Zip Code:47167-8211
Mailing Address - Country:US
Mailing Address - Phone:812-844-3918
Mailing Address - Fax:812-901-6204
Practice Address - Street 1:3358 W VINCENNES TRL
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:IN
Practice Address - Zip Code:47167-8211
Practice Address - Country:US
Practice Address - Phone:812-844-3918
Practice Address - Fax:812-901-6204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)