Provider Demographics
NPI:1952608564
Name:LAMBORN, AMY BENTLEY (MDIV, PHD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:BENTLEY
Last Name:LAMBORN
Suffix:
Gender:F
Credentials:MDIV, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5030 HENRY HUDSON PKWY E
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-3216
Mailing Address - Country:US
Mailing Address - Phone:718-548-6806
Mailing Address - Fax:
Practice Address - Street 1:26 W 9TH ST
Practice Address - Street 2:#7A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8971
Practice Address - Country:US
Practice Address - Phone:917-557-0532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral