Provider Demographics
NPI:1629009220
Name:LAMB, CAROLYN G (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:G
Last Name:LAMB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2229 STELLY DR
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39531-2907
Mailing Address - Country:US
Mailing Address - Phone:228-377-7016
Mailing Address - Fax:228-377-4725
Practice Address - Street 1:301 FISHER ST
Practice Address - Street 2:KEESLER MEDICAL CENTER
Practice Address - City:KEESLER AFB
Practice Address - State:MS
Practice Address - Zip Code:39534-2508
Practice Address - Country:US
Practice Address - Phone:228-377-6216
Practice Address - Fax:228-377-4725
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC00931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical