Individual
ELLEN TAYLOR BUDDEKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1951 BISHOP LN STE 300, LOUISVILLE, KY 40218-1950
(502) 446-5610
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
253729
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253729
—
KY
05
—
7100567400
—
KY
Enumeration date
01/29/2018
Last updated
10/21/2021
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