Provider Demographics
NPI:1922285006
Name:LAMB, REBECCA JEAN (MA)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JEAN
Last Name:LAMB
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 STANWELL ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-7994
Mailing Address - Country:US
Mailing Address - Phone:575-496-1179
Mailing Address - Fax:719-309-0858
Practice Address - Street 1:172 STANWELL ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906
Practice Address - Country:US
Practice Address - Phone:575-496-1179
Practice Address - Fax:719-309-0858
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
NM0063981101YP2500X
NM0118421101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional