MEDICARE: LINDA LUDDINGTON M.S., LPC

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	101YM0800X	Mental Health Counselor	4104	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174597504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA LUDDINGTON M.S., LPC

Provider Business Mailing Address
First Line	:	PO BOX 60482
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80960-0482
Country	:	US
Telephone Number	:	719-534-3776
Fax Number	:	719-362-5577

Provider Business Practice Location Address
First Line	:	1301 S 8TH ST
Second Line	:	SUITE 304C
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80905-7335
Country	:	US
Telephone Number	:	719-534-3776
Fax Number	:	719-362-5577

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	09/03/2010

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