Provider Demographics
NPI:1477529816
Name:WIDGEON-HAMMONDS, LYNETTE S (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LYNETTE
Middle Name:S
Last Name:WIDGEON-HAMMONDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5324 ALTON DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-5902
Mailing Address - Country:US
Mailing Address - Phone:757-420-0530
Mailing Address - Fax:757-420-0488
Practice Address - Street 1:640 INDEPENDENCE PKWY
Practice Address - Street 2:100
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-5205
Practice Address - Country:US
Practice Address - Phone:757-420-0530
Practice Address - Fax:757-420-0488
Is Sole Proprietor?:No
Enumeration Date:2006-02-26
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040017851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical