Doctor Name: | DR. WILLIAM LOUIS LICAMELE |
NPI Number: | 1104942754 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 6790 |
Business Practice Address: | 6760 Old Mclean Village Dr. Mclean, VA - 221013906 |
Business Phone Number: | 7037346927 |
Business Fax Number: | |
Mailing Address: | 6760 Old Mclean Village Dr, MCLEAN |
State: | VA |
Postal Code: | 221013906 |
Phone Number: | 7037346927 |
Fax Number: | |
NPI Enumeration Date: | 03/22/2007 |
NPI Last Update Date: | 06/08/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084P0804X |
License Number: | 6790 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Child & Adolescent Psychiatry |
Taxonomy Definition: | Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |