Provider Demographics
NPI:1972699890
Name:LAMBERT, LAURIE LEE (MSW)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:LEE
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 WATERMAN ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-3109
Mailing Address - Country:US
Mailing Address - Phone:401-861-3804
Mailing Address - Fax:401-861-3804
Practice Address - Street 1:163 WATERMAN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-3109
Practice Address - Country:US
Practice Address - Phone:401-861-3804
Practice Address - Fax:401-861-3804
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW013141041C0700X
MA1079631041C0700X
CALCS157951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI239015OtherBLUE CROSS
MA239015OtherBLUE CROSS
MA239015OtherBLUE CROSS