Provider Demographics
NPI:1871564872
Name:LUDGATE, JOHN W (PHD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:LUDGATE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 BILTMORE AVE
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4543
Mailing Address - Country:US
Mailing Address - Phone:828-359-1177
Mailing Address - Fax:828-350-1188
Practice Address - Street 1:417 BILTMORE AVE
Practice Address - Street 2:SUITE 2E
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4543
Practice Address - Country:US
Practice Address - Phone:828-350-1177
Practice Address - Fax:828-350-1188
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3540103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA285526OtherANTHEM BLUE CROSS
VA007703171Medicaid
VA220800OtherVALUEOPTIONS
VA007703171Medicaid