Healthcare Provider Details

I. General information

NPI: 1912153800
Provider Name (Legal Business Name): MICHAEL CANUTE LAMBERT PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2008
Last Update Date: 01/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 N. HARRISON AVENUE SUITE 100
CARY NC
27513-5597
US

IV. Provider business mailing address

1901 N. HARRISON AVENUE SUITE 100
CARY NC
27513-5597
US

V. Phone/Fax

Practice location:
  • Phone: 919-677-0101
  • Fax: 919-677-0113
Mailing address:
  • Phone: 919-677-0101
  • Fax: 919-677-0113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2004029370
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3665
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: