Provider Demographics
NPI:1952893489
Name:LAMBERT, AMIE M (LISW-S)
Entity type:Individual
Prefix:
First Name:AMIE
Middle Name:M
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:AMIE
Other - Middle Name:
Other - Last Name:BUTCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2780 AIRPORT DRIVE
Mailing Address - Street 2:SUITE 100 - BILLING/CREDENTIALING DEPT.
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-2289
Mailing Address - Country:US
Mailing Address - Phone:614-859-1906
Mailing Address - Fax:614-645-5517
Practice Address - Street 1:2300 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204
Practice Address - Country:US
Practice Address - Phone:614-645-2300
Practice Address - Fax:614-645-2333
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.21025921041C0700X
OHS.18022321041C0700X
I.2102592-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0292057Medicaid