Healthcare Provider Details

I. General information

NPI: 1811469265
Provider Name (Legal Business Name): KARA D. LUDEKER LCSW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2018
Last Update Date: 04/26/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1103 WEST STAN SCHLUETER LOOP BUILDING A SUITE 100
KILLEEN TX
76549
US

IV. Provider business mailing address

701 FARM TO MARKET 685 SUITE 450
PFLUGERVILLE TX
78660
US

V. Phone/Fax

Practice location:
  • Phone: 254-213-7847
  • Fax: 254-312-2002
Mailing address:
  • Phone: 737-587-3737
  • Fax: 254-312-2003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number67061
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: