Healthcare Provider Details

I. General information

NPI: 1053323022
Provider Name (Legal Business Name): LAMPION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 05/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 S HEBRON AVE
EVANSVILLE IN
47714-4048
US

IV. Provider business mailing address

655 S HEBRON AVE
EVANSVILLE IN
47714-4048
US

V. Phone/Fax

Practice location:
  • Phone: 812-471-1776
  • Fax: 812-469-2000
Mailing address:
  • Phone: 812-471-1776
  • Fax: 812-469-2000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34000984A
License Number StateIN

VIII. Authorized Official

Name: LYNN KYLE
Title or Position: EXECUTIVE DIRECTOR
Credential: LCSW
Phone: 812-471-1776