Provider Demographics
NPI:1477005247
Name:LAMP, MELINDA
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:LAMP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S COTNER BLVD
Mailing Address - Street 2:SUITE 119
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-3901
Mailing Address - Country:US
Mailing Address - Phone:402-261-6667
Mailing Address - Fax:
Practice Address - Street 1:600 S COTNER BLVD
Practice Address - Street 2:SUITE 119
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-3901
Practice Address - Country:US
Practice Address - Phone:402-261-6667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-27
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10831101YM0800X
NEP-1445101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)