Provider Demographics
NPI:1639509573
Name:LAMB, JENNIFER (LSCSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:LAMB
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12
Mailing Address - Street 2:
Mailing Address - City:OZAWKIE
Mailing Address - State:KS
Mailing Address - Zip Code:66070-0012
Mailing Address - Country:US
Mailing Address - Phone:785-640-8851
Mailing Address - Fax:
Practice Address - Street 1:100 S DAWSON ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:KS
Practice Address - Zip Code:66512-9586
Practice Address - Country:US
Practice Address - Phone:785-640-8851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS42261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical