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NPI Code Detail

MEDICARE: JOHN W LAMB JR. QMHA

MEDICARE: JOHN W LAMB JR. QMHA
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
1101YM0800XMental Health Counselor54627NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1274455064OTHERNVQMHA

General Provider Information

NPI Number : 1316224330
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN W LAMB JR. QMHA
Provider Business Mailing Address
First Line : 5824 PIRATE SHIP DR
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-3496
Country : US
Telephone Number : 702-586-8693
Fax Number : 702-476-2690
Provider Business Practice Location Address
First Line : 5715 W ALEXANDER
Second Line : SUITE 155
City : LAS VEGAS
State : NV
Zip : 89130-2807
Country : US
Telephone Number : 702-586-8693
Fax Number : 702-476-2690
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2011
Last Update Date : 11/04/2011

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