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Organization
SUBSTANCE ABUSE PROFESSIONALS OF TIDEWATER
Active
Organization
SUBSTANCE ABUSE PROFESSIONALS OF TIDEWATER
Active
Other names
Peggy Lidstrom LCSW
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARGARET RAY LIDSTROM LCSW (MANAGER)
(757) 636-9187
Entity
Organization
Contact information
Practice address
2940 N LYNNHAVEN RD STE 130, VIRGINIA BEACH, VA 23452-6949
(757) 636-9187
(888) 785-9387
Mailing address
2940 N LYNNHAVEN RD STE 130, VIRGINIA BEACH, VA 23452-6949
(757) 636-9187
(888) 785-9387
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904000638
VA
Other
Enumeration date
10/10/2016
Last updated
11/14/2016
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