Provider Demographics
NPI:1700033941
Name:LAMBIDONI, EVANGELIA (EDM)
Entity Type:Individual
Prefix:MS
First Name:EVANGELIA
Middle Name:
Last Name:LAMBIDONI
Suffix:
Gender:F
Credentials:EDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 COMMONWEALTH AVE
Mailing Address - Street 2:APT. 6
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-3613
Mailing Address - Country:US
Mailing Address - Phone:617-505-5955
Mailing Address - Fax:
Practice Address - Street 1:1269 BEACON ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5248
Practice Address - Country:US
Practice Address - Phone:617-232-1303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA396906101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool