Calvin Lidmark, LPC, LAC, CCMHC, MAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

ACD-167 Issued in CO

Practice address

1638 Elwell St
BLDG 6236, RM 229
Ft Carson, CO 80913-4356

Phone

(719) 526-2196

Fax

(719) 526-1983

NPI assigned

Sep 17, 2006

Last updated

Sep 3, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378166400000",
    "number": "1700983483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR",
            "address_2": "BLDG 7505, RM 163",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-526-6073",
            "fax_number": "719-526-7732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 ELWELL ST",
            "address_2": "BLDG 6236, RM 229",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "809134356",
            "telephone_number": "719-526-2196",
            "fax_number": "719-526-1983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDMARK",
        "first_name": "CALVIN",
        "credential": "LPC, LAC, CCMHC, MAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2013-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "1098",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACD-167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11703979",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cara Leonard
• Journi M Leonguerrero
• Christine Levy, R.D
• Talisha Lewis-Wooden
• Harland G Lewis Jr., DDS
• Peter Albert Liehr Jr., M.D.
• Nicole Eunhae Lim, DDS
• Alfred Miles Limary, RN
• Jerome Paul Limoge Jr., M.D.
• Patty Jean Linville, MA

• Addiction (Substance Use Disorder) Counselor in Fort Carson, CO
• Providers in Fort Carson, CO by specialty
• Addiction (Substance Use Disorder) Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.