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General NPI Number Information
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NPI Number | 1770897175
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Entity Type | Individual
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Provider Name | LARRY TIN-LOK LAM LCSW, LISW-CP
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Gender | Male
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Dates
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Enumeration Date | 07/28/2010
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Last Update Date | 02/29/2016
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Provider Practice Location Address
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Address Line | 616 HUTTON ST
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City | RALEIGH
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State | NC
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Zip | 27606-1444
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Country | US
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Telephone | 919-861-2865
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Fax |
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Provider Business Mailing Address
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Address Line | 155 W WATSON RD
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City | BENSON
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State | NC
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Zip | 27504-6929
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Country | US
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Telephone | 215-266-3981
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P005914
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C008115
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License Number State | NC
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