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NPI Code Detail

MEDICARE: JESSE LUDWIG LCPC

MEDICARE: JESSE LUDWIG LCPC
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
1101YM0800XMental Health CounselorLC9142MD

General Provider Information

NPI Number : 1962054783
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSE LUDWIG LCPC
Provider Business Mailing Address
First Line : 10715 CHARTER DR STE 130
Second Line :
City : COLUMBIA
State : MD
Zip : 21044-2892
Country : US
Telephone Number : 443-653-1363
Fax Number :
Provider Business Practice Location Address
First Line : 10715 CHARTER DR STE 130
Second Line :
City : COLUMBIA
State : MD
Zip : 21044-2892
Country : US
Telephone Number : 443-653-1363
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2019
Last Update Date : 07/11/2019

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Directions to “ JESSE LUDWIG LCPC” Practice Location

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