Healthcare Provider Details
I. General information
NPI: 1902176415
Provider Name (Legal Business Name): LAMBERT PSYCHOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/01/2012
Last Update Date: 11/03/2024
Certification Date: 11/03/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14275 MIDWAY RD STE 260
ADDISON TX
75001-3613
US
IV. Provider business mailing address
3465 NATIONAL DR STE 215
PLANO TX
75025-1095
US
V. Phone/Fax
- Phone: 469-665-9445
- Fax:
- Phone: 972-987-5460
- Fax: 855-437-2354
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 33988 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 33988 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | 33988 |
| License Number State | TX |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | 33988 |
| License Number State | TX |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TF0000X |
| Taxonomy | Family Psychologist |
| License Number | 33988 |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
KEVIN
C.
LAMBERT
Title or Position: CEO/LICENSED PSYCHOLOGIST
Credential: PSY.D.
Phone: 469-665-9445