Healthcare Provider Details

I. General information

NPI: 1922334465
Provider Name (Legal Business Name): AMANDA KAY LAMBERTI MA, LCPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2009
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

954 BROOKS RACKLEY RD
DALLAS GA
30157-9241
US

IV. Provider business mailing address

954 BROOKS RACKLEY RD
DALLAS GA
30157-9241
US

V. Phone/Fax

Practice location:
  • Phone: 678-923-4578
  • Fax: 406-259-4638
Mailing address:
  • Phone: 678-923-4578
  • Fax: 406-259-4638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberBBH-LCPC-LIC-42501
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: