Provider Demographics
NPI:1841783388
Name:LAMM, GWYNN CATHLEEN (LPC)
Entity Type:Individual
Prefix:MS
First Name:GWYNN
Middle Name:CATHLEEN
Last Name:LAMM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:GWYNN
Other - Middle Name:CATHLEEN
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7265 KENWOOD RD STE 321
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-4416
Mailing Address - Country:US
Mailing Address - Phone:513-657-9132
Mailing Address - Fax:
Practice Address - Street 1:7265 KENWOOD RD STE 321
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-4416
Practice Address - Country:US
Practice Address - Phone:513-657-9132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-10
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1801178101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1417338328OtherFEE FOR SERVICE