Provider Demographics
NPI:1710078043
Name:LAMBERT, SUSAN BRASWELL (LPC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:BRASWELL
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:696 N SPENCE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534
Mailing Address - Country:US
Mailing Address - Phone:919-583-8448
Mailing Address - Fax:919-583-8448
Practice Address - Street 1:696 N SPENCE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534
Practice Address - Country:US
Practice Address - Phone:919-583-8448
Practice Address - Fax:919-583-8448
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10078OtherBCBS
NC6102084Medicaid