Provider Demographics
NPI:1013789916
Name:LAMB, RYAN LEE (CDCA, PRS)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:LEE
Last Name:LAMB
Suffix:
Gender:M
Credentials:CDCA, PRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 SYLVESTER ST
Mailing Address - Street 2:
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-2324
Mailing Address - Country:US
Mailing Address - Phone:567-289-1529
Mailing Address - Fax:
Practice Address - Street 1:131 SYLVESTER ST
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-2324
Practice Address - Country:US
Practice Address - Phone:567-289-1529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.183834101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)