Provider Demographics
NPI:1023769528
Name:LAMBERT, MARY ALLISON (LCSW)
Entity type:Individual
Prefix:MISS
First Name:MARY
Middle Name:ALLISON
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 N ORLANDO AVE APT 277
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4604
Mailing Address - Country:US
Mailing Address - Phone:407-668-8142
Mailing Address - Fax:
Practice Address - Street 1:955 N ORLANDO AVE APT 277
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4604
Practice Address - Country:US
Practice Address - Phone:407-668-8142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-16
Last Update Date:2022-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL179541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical