Provider Demographics
NPI:1033534797
Name:LAMB, JESSICA (MS, LLP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:LAMB
Suffix:
Gender:F
Credentials:MS, LLP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:DOYEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 S MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-1975
Mailing Address - Country:US
Mailing Address - Phone:248-529-6383
Mailing Address - Fax:866-250-6455
Practice Address - Street 1:120 S MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-1975
Practice Address - Country:US
Practice Address - Phone:248-529-6383
Practice Address - Fax:866-250-6455
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC1900X
MI104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling