Provider Demographics
NPI:1588006951
Name:LAMB, MCKENZIE (PCC)
Entity Type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:
Last Name:LAMB
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 ARMSTRONG ST
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:OH
Mailing Address - Zip Code:45885-1800
Mailing Address - Country:US
Mailing Address - Phone:419-394-7451
Mailing Address - Fax:419-394-8051
Practice Address - Street 1:720 ARMSTRONG ST
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:OH
Practice Address - Zip Code:45885-1800
Practice Address - Country:US
Practice Address - Phone:419-394-7451
Practice Address - Fax:419-394-8051
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0800223101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional