Provider Demographics
NPI:1215028782
Name:CLOUD, LLOYD EZEKIEL (LCSW)
Entity Type:Individual
Prefix:
First Name:LLOYD
Middle Name:EZEKIEL
Last Name:CLOUD
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 1:5731 GEORGE WASHINGTON MEM HWY STE 4A
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692-2685
Mailing Address - Country:US
Mailing Address - Phone:860-301-1664
Mailing Address - Fax:757-890-6204
Practice Address - Street 1:5731 GEORGE WASHINGTON MEM HWY STE 4A
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23692-2685
Practice Address - Country:US
Practice Address - Phone:860-301-1664
Practice Address - Fax:757-890-6204
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040089791041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT005725OtherLCSW
CT800003687Medicare PIN