Individual
KELLY C DIGUILIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5500 WHITE SWALLOW WAY, CHESAPEAKE, VA 23321-2330
(707) 490-9764
Mailing address
5500 WHITE SWALLOW WAY, CHESAPEAKE, VA 23321-2330
(707) 490-9764
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
467
AK
1041C0700X
Clinical Social Worker
Primary
0904009898
VA
1041C0700X
Clinical Social Worker
C013089
NC
1041C0700X
Clinical Social Worker
SW19515
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0904009898
LCSW
VA
05
—
1891189429
—
VA
01
—
508559
MASTER IN ADDICTION CERTIFICATION
AK
01
—
C013089
LCSW
NC
01
—
SW19515
LCSW
FL
Enumeration date
03/20/2015
Last updated
09/06/2022
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