Individual provider Active NPI

Anthony Duff Ludlum, LPC

  • Mental Health Counselor
  • Scottsdale, AZ
National Provider Identifier
1669138871
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC-20473 Issued in AZ
Practice address
14300 N Northsight Blvd Ste 101
Scottsdale, AZ 85260-3673
Phone
(602) 550-0175
NPI assigned
Nov 11, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC-20473 AZ Primary

Addresses

Primary practice location

14300 N Northsight Blvd Ste 101
Scottsdale, AZ 85260-3673

Mailing address

3801 W Ironwood Dr
Phoenix, AZ 85051-1154
Phone (602) 315-7928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC-20473AZMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Trauma Healing Center LLC Mental Health CurrentSince Nov 16, 2021 Accepting new patients

Locations

14300 N Northsight Blvd
Ste 101
Scottsdale, AZ 85260
Phone (480) 390-2610

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": "1636588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1669138871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 W IRONWOOD DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850511154",
            "telephone_number": "602-315-7928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 N NORTHSIGHT BLVD STE 101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603673",
            "telephone_number": "602-550-0175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDLUM",
        "first_name": "ANTHONY",
        "middle_name": "DUFF",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-11",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-20473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.