Provider Demographics
NPI:1669138871
Name:LUDLUM, ANTHONY DUFF (LPC)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:DUFF
Last Name:LUDLUM
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 W IRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-1154
Mailing Address - Country:US
Mailing Address - Phone:602-315-7928
Mailing Address - Fax:
Practice Address - Street 1:14300 N NORTHSIGHT BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-3673
Practice Address - Country:US
Practice Address - Phone:602-550-0175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-20473101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health