Provider Demographics
NPI:1235317520
Name:LAMB, RAYMOND ULYSSES JR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:ULYSSES
Last Name:LAMB
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 1/2 N GARDNER ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-5711
Mailing Address - Country:US
Mailing Address - Phone:323-317-8650
Mailing Address - Fax:
Practice Address - Street 1:642 1/2 N GARDNER ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-5711
Practice Address - Country:US
Practice Address - Phone:323-317-8650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA240251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical