Provider Demographics
NPI:1881876696
Name:LUDWIG, AUBREY HEATHER (LSW)
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:HEATHER
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 WALNUT ST STE 803
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4704
Mailing Address - Country:US
Mailing Address - Phone:215-715-8493
Mailing Address - Fax:
Practice Address - Street 1:1315 WALNUT ST STE 803
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4704
Practice Address - Country:US
Practice Address - Phone:215-715-8493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-04
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1247891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical