Healthcare Provider Details

I. General information

NPI: 1184944340
Provider Name (Legal Business Name): KEVIN C. LAMBERT PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2010
Last Update Date: 11/05/2024
Certification Date: 11/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3465 NATIONAL DR STE 215
PLANO TX
75025-1095
US

IV. Provider business mailing address

3465 NATIONAL DR STE 215
PLANO TX
75025-1095
US

V. Phone/Fax

Practice location:
  • Phone: 972-987-5460
  • Fax: 855-437-2354
Mailing address:
  • Phone: 972-987-5460
  • Fax: 855-437-2354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number33988
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number33988
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number33988
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number33988
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: