Provider Demographics
NPI:1427479179
Name:LUDWIG, MYRNA ELAINE (LCSW)
Entity type:Individual
Prefix:MS
First Name:MYRNA
Middle Name:ELAINE
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 DEBBIE LN
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-1605
Mailing Address - Country:US
Mailing Address - Phone:609-448-3860
Mailing Address - Fax:
Practice Address - Street 1:31 DEBBIE LN
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-1605
Practice Address - Country:US
Practice Address - Phone:609-448-3860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-25
Last Update Date:2013-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL055647001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical