Provider Demographics
NPI:1326825456
Name:LAMPE, ANSON (LPCC, BC-DMT, GL-CMA)
Entity Type:Individual
Prefix:
First Name:ANSON
Middle Name:
Last Name:LAMPE
Suffix:
Gender:F
Credentials:LPCC, BC-DMT, GL-CMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 ILLINOIS AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45410-2034
Mailing Address - Country:US
Mailing Address - Phone:937-287-5673
Mailing Address - Fax:
Practice Address - Street 1:144 ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45410-2034
Practice Address - Country:US
Practice Address - Phone:937-287-5673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2001740103TC1900X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling