# CALVIN LIDMARK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1700983483
- **Gender:** Man
- **Credential:** LPC, LAC, CCMHC, MAC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | ACD-167 | CO | Yes |
| 101YP2500X | Professional Counselor | 1098 | CO | — |

## Other

- **Enumeration date:** 09/17/2006
- **Last updated:** 09/03/2013