Healthcare Provider Details

I. General information

NPI: 1467101618
Provider Name (Legal Business Name): LAURA LYNETTE LAMP-O'MEARA CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 PIKE ST
MARIETTA OH
45750-3522
US

IV. Provider business mailing address

1017 PIKE ST
MARIETTA OH
45750-3522
US

V. Phone/Fax

Practice location:
  • Phone: 740-371-7007
  • Fax:
Mailing address:
  • Phone: 304-239-5355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.188048
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberAPS.002198
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: