Provider Demographics
NPI:1750428421
Name:LAMBERT, SANDRA MARIE (LMSW)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:MARIE
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 DRUID HILL RD
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-1043
Mailing Address - Country:US
Mailing Address - Phone:631-331-7466
Mailing Address - Fax:631-331-7466
Practice Address - Street 1:25 DRUID HILL RD
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-1043
Practice Address - Country:US
Practice Address - Phone:631-331-7466
Practice Address - Fax:631-331-7466
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040556-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical