Provider Demographics
NPI:1124040175
Name:PEOPLES-LAMBERT, SHANELLE LANIECE
Entity Type:Individual
Prefix:MS
First Name:SHANELLE
Middle Name:LANIECE
Last Name:PEOPLES-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 1:6115 CAMP BOWIE BLVD STE 298
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-5508
Mailing Address - Country:US
Mailing Address - Phone:682-238-0202
Mailing Address - Fax:
Practice Address - Street 1:6115 CAMP BOWIE BLVD STE 298
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-5508
Practice Address - Country:US
Practice Address - Phone:682-238-0202
Practice Address - Fax:682-316-9219
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75099101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional