Provider Demographics
NPI:1881841633
Name:WOODLAND, CALVIN EMMANUEL (EDD, PSYD)
Entity Type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:EMMANUEL
Last Name:WOODLAND
Suffix:
Gender:M
Credentials:EDD, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 CHAPMAN RD
Mailing Address - Street 2:SUITE 203A
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5490
Mailing Address - Country:US
Mailing Address - Phone:302-266-4396
Mailing Address - Fax:302-266-4402
Practice Address - Street 1:260 CHAPMAN RD
Practice Address - Street 2:SUITE 203A
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5490
Practice Address - Country:US
Practice Address - Phone:302-266-4396
Practice Address - Fax:302-266-4402
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-23
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC13932101YM0800X
NJ#3700PC0212900101YM0800X
FL#MH3304101YM0800X
DEPC0000423101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health