Healthcare Provider Details

I. General information

NPI: 1336462936
Provider Name (Legal Business Name): STACEY J LAMBERT MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2010
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CENTERPOINT DR STE 105
MIDDLETOWN CT
06457-7568
US

IV. Provider business mailing address

101 CENTERPOINT DR STE 105
MIDDLETOWN CT
06457-7568
US

V. Phone/Fax

Practice location:
  • Phone: 860-215-2259
  • Fax:
Mailing address:
  • Phone: 860-215-2259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberDP00943538
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberDP00943538
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: