MEDICARE: STEVEN D LAMBERT LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC005375	GA

General Provider Information

NPI Number	:	1134365646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN D LAMBERT LPC

Provider Business Mailing Address
First Line	:	PO BOX 4666
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30061-4666
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	77 COLE ST NE
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30060-2030
Country	:	US
Telephone Number	:	678-491-3983
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2009
Last Update Date	:	01/05/2009

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