Lidmark, Calvin

Lidmark, Calvin is an individual health care provider with primary practice located at 1638 Elwell St Bldg 6236, Rm 229, Ft Carson CO 80913-4356. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Lidmark, Calvin can be contacted via phone (719) 526-2196.

Contact Information

Primary practice address
1638 Elwell St Bldg 6236, Rm 229 Ft Carson CO 80913-4356
Phone: (719) 526-2196
Fax: (719) 526-1983
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 1098 Colorado
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X ACD-167 Colorado

Profile Details

NPI number 1700983483
LBN Legal business name Lidmark, Calvin
Credentials LPC, LAC, CCMHC, MAC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 17th, 2006
Last updated Sep 3rd, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700983483 NPPES
Colorado Other 11703979 CAQH

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