Provider Demographics
NPI:1598541203
Name:LAMBERT, LANDON (LGSW)
Entity Type:Individual
Prefix:
First Name:LANDON
Middle Name:
Last Name:LAMBERT
Suffix:
Gender:M
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 ACKERMAN RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-0913
Mailing Address - Country:US
Mailing Address - Phone:801-859-6310
Mailing Address - Fax:
Practice Address - Street 1:295 HIGH ST STE 3
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-5449
Practice Address - Country:US
Practice Address - Phone:304-363-4265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBP00946672104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker