Provider Demographics
NPI:1407476898
Name:LAMB, CHRISTIE LARAE (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:LARAE
Last Name:LAMB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4026 E MENAN LORENZO HWY
Mailing Address - Street 2:
Mailing Address - City:RIGBY
Mailing Address - State:ID
Mailing Address - Zip Code:83442-5168
Mailing Address - Country:US
Mailing Address - Phone:208-313-9996
Mailing Address - Fax:208-319-5561
Practice Address - Street 1:130 N 1ST W
Practice Address - Street 2:
Practice Address - City:RIGBY
Practice Address - State:ID
Practice Address - Zip Code:83442-1377
Practice Address - Country:US
Practice Address - Phone:208-351-5539
Practice Address - Fax:208-319-5561
Is Sole Proprietor?:No
Enumeration Date:2020-04-25
Last Update Date:2020-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID316401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical