Leisa Dianne Ludlam, PHD is a medicare enrolled "Psychologist - Clinical" provider in Pace, Florida. She graduated from medical school in 1988 and has 36 years of diverse experience with area of expertise as Clinical Psychologist. Her current practice location is
4509 Woodbine Rd, Pace, Florida. You can reach out to her office (for appointments etc.) via phone at
(850) 995-2500.
Leisa Dianne Ludlam is licensed to practice in Florida (license number PY0004705) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1497781835.
Healthcare Provider's Profile
Full Name | Leisa Dianne Ludlam |
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Gender | Female |
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Speciality | Clinical Psychologist |
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Experience | 36 Years |
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Location | 4509 Woodbine Rd, Pace, Florida |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Leisa Dianne Ludlam graduated from medical school in 1988
NPI Data:
- NPI Number: 1497781835
- Provider Enumeration Date: 06/25/2006
- Last Update Date: 06/05/2008
Medicare PECOS Information:
- PECOS PAC ID: 2365415585
- Enrollment ID: I20040817000093
Medical Identifiers
Medical identifiers for Leisa Dianne Ludlam such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1497781835 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TC0700X | Psychologist - Clinical | PY0004705 (Florida) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Leisa Dianne Ludlam is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Leisa Dianne Ludlam, PHD 4509 Woodbine Rd, Pace, FL 32571-8706 Ph: (850) 995-2500 | Leisa Dianne Ludlam, PHD 4509 Woodbine Rd, Pace, FL 32571-8706 Ph: (850) 995-2500 |
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