Leisa D. Ludlam PH.D., P.a.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY0004705 Issued in FL

Legal business name

LEISA D. LUDLAM PH.D., P.A.

Practice address

9007 University Pkwy
Pensacola, FL 32514-5525

Phone

(850) 484-0926

Fax

(850) 484-0988

NPI assigned

Jun 24, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Leisa Dianne Ludlam, PH.D.

Title

President

Phone

(850) 484-9026

Specialties & licenses 1

Addresses

Tax ID family

Leisa D Ludlam PHD PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Leisa D. Ludlam, PH.D.,P.a.

  • Psychologist
  • Pace, FL
  • NPI 1295271443
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255367918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9007 UNIVERSITY PKWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325145525",
            "telephone_number": "850-484-0926",
            "fax_number": "850-484-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9007 UNIVERSITY PKWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325145525",
            "telephone_number": "850-484-0926",
            "fax_number": "850-484-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEISA D. LUDLAM PH.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUDLAM",
        "authorized_official_first_name": "LEISA",
        "authorized_official_middle_name": "DIANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-484-9026",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0004705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn Faye Legrand, COTA/L
• Shawn Legrand
• Mallorie Anne Lehman
• Paige Anne Lehmann, ATC
• Alexis Dawn Lehrmann, BCBA
• Rachel Elizabeth Lemaitre, PA-C
• David E Lemay, M.D.
• Sarah Elizabeth Lemon, APRN
• Terri Lemon
• Luis Lemus, MD

• Clinical Psychologist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.