Healthcare Provider Details

I. General information

NPI: 1346952199
Provider Name (Legal Business Name): KRISTINE ANN LUDWIG LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2022
Last Update Date: 03/07/2023
Certification Date: 03/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9809 S FRANKLIN DR STE 302
FRANKLIN WI
53132-8885
US

IV. Provider business mailing address

9809 S FRANKLIN DR STE 302
FRANKLIN WI
53132-8885
US

V. Phone/Fax

Practice location:
  • Phone: 262-789-1191
  • Fax: 262-821-6180
Mailing address:
  • Phone: 262-789-1191
  • Fax: 262-821-6180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8590-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: