Provider Demographics
NPI:1073019428
Name:LAMBERT, STACY-ANN D
Entity Type:Individual
Prefix:
First Name:STACY-ANN
Middle Name:D
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 SAINT GEORGES AVE STE 118
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-2713
Mailing Address - Country:US
Mailing Address - Phone:848-236-5091
Mailing Address - Fax:848-236-5092
Practice Address - Street 1:1600 SAINT GEORGES AVENUE
Practice Address - Street 2:SUITE 118
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2713
Practice Address - Country:US
Practice Address - Phone:848-236-5091
Practice Address - Fax:848-236-5092
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057181001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical