Provider Demographics
NPI:1386643278
Name:LAMB, ERIC H (LCSW)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:H
Last Name:LAMB
Suffix:
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 1:495 GRAND BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32550-1897
Mailing Address - Country:US
Mailing Address - Phone:847-404-4855
Mailing Address - Fax:850-613-6184
Practice Address - Street 1:495 GRAND BLVD STE 206
Practice Address - Street 2:
Practice Address - City:MIRAMAR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32550-1897
Practice Address - Country:US
Practice Address - Phone:847-404-4855
Practice Address - Fax:850-613-6184
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490060181041C0700X
MSMS-C75521041C0700X
FLSW121141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00284506Medicaid
FL023851900Medicaid
FL023851900Medicaid
FLID605AOtherMEDICARE PTAN
MS302I807708Medicare PIN
ILS10807Medicare UPIN