Active NPI
Brandi Lynn Luedtke, PSYD
- Psychologist
- Phoenix, AZ
National Provider Identifier
1215249701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 650 E Indian School Rd
Phoenix, AZ 85012-1839 - Phone
- (480) 247-1682
- NPI assigned
- Jul 13, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
650 E Indian School Rd
Phoenix, AZ 85012-1839
Mailing address
11215 N 26TH St
Phoenix, AZ 85028-2548
Phone (937) 266-2059
Other practice location 1
814 N Durham St
Ulysses, KS 67880-1627
Phone (855) 224-3974
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nellie Health | Psychologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721952000000",
"number": "1215249701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11215 N 26TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850282548",
"telephone_number": "937-266-2059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 E INDIAN SCHOOL RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850121839",
"telephone_number": "480-247-1682"
}
],
"practiceLocations": [
{
"address_1": "814 N Durham St",
"address_purpose": "LOCATION",
"city": "Ulysses",
"state": "KS",
"postal_code": "678801627",
"country_code": "US",
"telephone_number": "855-224-3974",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LUEDTKE",
"first_name": "BRANDI",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-13",
"last_updated": "2024-07-26",
"certification_date": "2024-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.