Provider Demographics
NPI:1942624176
Name:LAMBERT, JOE M (LPC-IT, SAC-IT)
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:M
Last Name:LAMBERT
Suffix:
Gender:M
Credentials:LPC-IT, SAC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 W MAIN ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:STOUGHTON
Mailing Address - State:WI
Mailing Address - Zip Code:53589-2100
Mailing Address - Country:US
Mailing Address - Phone:608-873-7838
Mailing Address - Fax:877-674-2177
Practice Address - Street 1:135 W MAIN ST
Practice Address - Street 2:SUITE 207
Practice Address - City:STOUGHTON
Practice Address - State:WI
Practice Address - Zip Code:53589-2100
Practice Address - Country:US
Practice Address - Phone:608-873-7838
Practice Address - Fax:877-674-2177
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17067-130101YA0400X
WI2043-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional