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General NPI Number Information
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NPI Number | 1275720203
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Entity Type | Individual
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Provider Name | MICHAEL LAMMERT LCPC/CRADC
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Gender | Male
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Dates
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Enumeration Date | 10/03/2007
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Last Update Date | 10/04/2007
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Provider Practice Location Address
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Address Line | 1501 OLIVE ST
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City | LAWRENCEVILLE
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State | IL
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Zip | 62439-2269
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Country | US
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Telephone | 618-943-3451
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Fax | 618-943-4368
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Provider Business Mailing Address
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Address Line | PO BOX M 504 MICAH DRIVE
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City | OLNEY
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State | IL
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Zip | 62450-0913
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Country | US
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Telephone | 618-395-4306
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Fax | 618-395-4507
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | IL
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