MEDICARE: MICHELLE LUDLOW CACAD

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	101YA0400X	Addiction (Substance Use Disorder) Counselor		MD

General Provider Information

NPI Number	:	1275047581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE LUDLOW CACAD

Provider Business Mailing Address
First Line	:	3524 4TH ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21225-1812
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2233 ORLEANS ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21231-1334
Country	:	US
Telephone Number	:	443-393-2109
Fax Number	:

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

Provider Enumeration Date	:	11/22/2017
Last Update Date	:	11/22/2017

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Directions to “ MICHELLE LUDLOW CACAD” Practice Location

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