CALVIN LIDMARK LPC LAC CCMHC MAC NPI 1700983483

NPI Information

NPI: 1700983483
Provider Name: CALVIN LIDMARK, LPC, LAC, CCMHC, MAC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
1638 ELWELL ST
BLDG 6236, RM 229
FT CARSON, CO
ZIP 80913
Phone: (719) 526-2196
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Calvin Lidmark, LPC, LAC, CCMHC, MAC is an addiction (substance use disorder) counselor in Ft Carson, CO. Calvin Lidmark, LPC, LAC, CCMHC, MAC NPI is 1700983483. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1638 ELWELL ST
BLDG 6236, RM 229
FT CARSON, CO
ZIP 80913-356
Phone: (719) 526-2196
Fax: (719) 526-1983

The enumeration date for this NPI number is 9/17/2006 and was last updated on 9/3/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	1098	COLORADO	No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	ACD-167	COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	11703979	OTHER	COLORADO	CAQH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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