Provider Demographics
NPI:1366098493
Name:LAMB, EVERETT HEATH (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:EVERETT
Middle Name:HEATH
Last Name:LAMB
Suffix:
Gender:M
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 EARL GARRETT ST STE 106
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-4500
Mailing Address - Country:US
Mailing Address - Phone:830-391-8998
Mailing Address - Fax:
Practice Address - Street 1:327 EARL GARRETT ST STE 106
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-4500
Practice Address - Country:US
Practice Address - Phone:830-391-8998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-14
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX575331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical