Provider Demographics
NPI:1275239501
Name:LAMB, MADELEINE (LLMFT)
Entity Type:Individual
Prefix:
First Name:MADELEINE
Middle Name:
Last Name:LAMB
Suffix:
Gender:F
Credentials:LLMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1353 CARSTON LN
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-2106
Mailing Address - Country:US
Mailing Address - Phone:734-929-8499
Mailing Address - Fax:
Practice Address - Street 1:711 E GRAND RIVER AVE STE A
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-2474
Practice Address - Country:US
Practice Address - Phone:517-896-3592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4151001089106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist