Provider Demographics
NPI:1619127503
Name:LAMB, MATTHEW S (LPC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:S
Last Name:LAMB
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:MATTHEW
Other - Middle Name:STAFFORD
Other - Last Name:LAMB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:936 CHARLTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-5205
Mailing Address - Country:US
Mailing Address - Phone:434-207-2938
Mailing Address - Fax:
Practice Address - Street 1:500 OLD LYNCHBURG RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-6500
Practice Address - Country:US
Practice Address - Phone:434-972-1800
Practice Address - Fax:434-984-1297
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62747101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional