MEDICARE: DR. AMALIA HUMADA-LUDEKE, LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	0177351	NM

General Provider Information

NPI Number	:	1477910586
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. AMALIA HUMADA-LUDEKE, LMFT

Provider Business Mailing Address
First Line	:	PO BOX 5040
Second Line	:
City	:	SILVER CITY
State	:	NM
Zip	:	88062-5040
Country	:	US
Telephone Number	:	575-956-6135
Fax Number	:	575-956-6204

Provider Business Practice Location Address
First Line	:	530 HIGHWAY 180 W
Second Line	:
City	:	SILVER CITY
State	:	NM
Zip	:	88061-4400
Country	:	US
Telephone Number	:	505-231-9156
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	DR. AMALIA HUMADA-LUDEKE
Credential	:	LMFT
Telephone Number	:	505-231-9156

Provider Enumeration Date	:	01/20/2016
Last Update Date	:	07/21/2022

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