Provider Demographics
NPI:1174597504
Name:LUDDINGTON, LINDA (MS, LPC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:LUDDINGTON
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60482
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80960-0482
Mailing Address - Country:US
Mailing Address - Phone:719-534-3776
Mailing Address - Fax:719-362-5577
Practice Address - Street 1:1301 S 8TH ST
Practice Address - Street 2:SUITE 304C
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905-7335
Practice Address - Country:US
Practice Address - Phone:719-534-3776
Practice Address - Fax:719-362-5577
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4104101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO53271734Medicaid