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General NPI Number Information
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NPI Number | 1619127503
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Entity Type | Individual
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Provider Name | MATTHEW S. LAMB LPC
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Gender | Male
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Dates
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Enumeration Date | 09/26/2008
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Last Update Date | 11/26/2018
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Provider Practice Location Address
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Address Line | 500 OLD LYNCHBURG RD
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-6500
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Country | US
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Telephone | 434-972-1800
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Fax | 434-984-1297
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Provider Business Mailing Address
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Address Line | 936 CHARLTON AVE
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-5205
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Country | US
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Telephone | 434-207-2938
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 62747
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License Number State | TX
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