Provider Demographics
NPI:1083799605
Name:LIGGIO, CHARLES V (LCSW)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:V
Last Name:LIGGIO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 PERIMETER PKWY STE 206
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-5924
Mailing Address - Country:US
Mailing Address - Phone:757-428-7500
Mailing Address - Fax:757-428-7500
Practice Address - Street 1:1232 PERIMETER PKWY STE 206
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-5924
Practice Address - Country:US
Practice Address - Phone:757-428-7500
Practice Address - Fax:757-428-7500
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904001863101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00V767F27Medicare PIN