Provider Demographics
NPI:1659100139
Name:WILLIAMS, CALVIN DEMOND SR (LPC)
Entity type:Individual
Prefix:
First Name:CALVIN
Middle Name:DEMOND
Last Name:WILLIAMS
Suffix:SR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2319 GRANDY AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23509-2211
Mailing Address - Country:US
Mailing Address - Phone:757-773-1351
Mailing Address - Fax:443-320-9452
Practice Address - Street 1:548 BATTLEFIELD BLVD S
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-5363
Practice Address - Country:US
Practice Address - Phone:757-773-1351
Practice Address - Fax:443-320-9452
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
VA0701013813101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional