Provider Demographics
NPI:1003281643
Name:LAMBETH, BRENT J (CMHC)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:J
Last Name:LAMBETH
Suffix:
Gender:M
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 S MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-3834
Mailing Address - Country:US
Mailing Address - Phone:435-586-2500
Mailing Address - Fax:
Practice Address - Street 1:465 W 1600 N
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-7743
Practice Address - Country:US
Practice Address - Phone:435-586-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-08
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6985011-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health