Whitehead, Calvin Douglas
Whitehead, Calvin Douglas is an sole proprietor health care provider with primary practice located at 2217 Pineview Dr , Valdosta GA 31602-7316. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Whitehead, Calvin Douglas can be contacted via phone (229) 671-6611.Contact Information
Primary practice address
2217 Pineview Dr
Valdosta GA 31602-7316
Phone: (229) 671-6611
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | CSW004356 | Georgia |
Profile Details
| NPI number | 1134327927 |
|---|---|
| LBN Legal business name | Whitehead, Calvin Douglas |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 3rd, 2007 |
| Last updated | Apr 19th, 2011 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134327927 | NPPES |
| Georgia | MEDICAID | CSW004356 |
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