Provider Demographics
NPI:1255182408
Name:LAMPEN, JOHN CHARLES (MA, LP-MFT, BCABA)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:CHARLES
Last Name:LAMPEN
Suffix:
Gender:M
Credentials:MA, LP-MFT, BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MESEROLE ST APT 2D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-2471
Mailing Address - Country:US
Mailing Address - Phone:718-218-5048
Mailing Address - Fax:
Practice Address - Street 1:11 MESEROLE ST APT 2D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-2471
Practice Address - Country:US
Practice Address - Phone:718-218-5048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002261106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist