Provider Demographics
NPI:1649079468
Name:LAMBSON, PETER DEMARCUS (AMFT)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:DEMARCUS
Last Name:LAMBSON
Suffix:
Gender:
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2824 E SNOW MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84093-1945
Mailing Address - Country:US
Mailing Address - Phone:801-834-9710
Mailing Address - Fax:
Practice Address - Street 1:13222 TREE SPARROW DR STE 200&R210
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84096-2879
Practice Address - Country:US
Practice Address - Phone:801-432-0991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14210524-3904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist