Provider Demographics
NPI:1376947556
Name:LAMARE, VICKI LYN (LCSW)
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:LYN
Last Name:LAMARE
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 1:993 MARGE LN
Mailing Address - Street 2:
Mailing Address - City:MOLINO
Mailing Address - State:FL
Mailing Address - Zip Code:32577-5561
Mailing Address - Country:US
Mailing Address - Phone:850-964-2990
Mailing Address - Fax:
Practice Address - Street 1:1965 CAPITAL CIR NE STE 102
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-8402
Practice Address - Country:US
Practice Address - Phone:850-964-2990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-16
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW169791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical