Healthcare Provider Details

I. General information

NPI: 1124356902
Provider Name (Legal Business Name): SAMUEL SETH LAMPLE LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2009
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1790 N STATE ST
OREM UT
84057-2025
US

IV. Provider business mailing address

1790 N STATE ST
OREM UT
84057-2025
US

V. Phone/Fax

Practice location:
  • Phone: 801-224-8255
  • Fax: 801-224-8301
Mailing address:
  • Phone: 801-224-8255
  • Fax: 801-224-8301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14273481-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: