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General NPI Number Information
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NPI Number | 1801323217
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Entity Type | Individual
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Provider Name | KELLY NICOLE LAMB LPC, LCDC
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Gender | Female
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Dates
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Enumeration Date | 05/16/2017
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Last Update Date | 05/16/2017
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Provider Practice Location Address
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Address Line | 1038 TEXAS YES BLVD
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City | ROBSTOWN
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State | TX
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Zip | 78380-6142
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Country | US
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Telephone | 361-886-1449
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Fax |
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Provider Business Mailing Address
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Address Line | 3210 SHALLOW CREEK DR
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City | CORPUS CHRISTI
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State | TX
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Zip | 78410-5789
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Country | US
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Telephone | 361-739-7932
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 12252
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 73426
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License Number State | TX
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