Provider Demographics
NPI:1548315997
Name:LUDEWIG, DORIS NATALIE (LCSW-R)
Entity type:Individual
Prefix:MRS
First Name:DORIS NATALIE
Middle Name:
Last Name:LUDEWIG
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:D. NATALIE
Other - Middle Name:NATALIE
Other - Last Name:DIAZ LUDEWIG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:21 HERBERT AVENUE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-3403
Mailing Address - Country:US
Mailing Address - Phone:914-439-3265
Mailing Address - Fax:
Practice Address - Street 1:21 HERBERT AVENUE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-3403
Practice Address - Country:US
Practice Address - Phone:914-439-3265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
NY073992251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY082978OtherLCSW
NY5635364OtherCIGNA
NY04210931Medicaid