Basic Information
| Provider Information | |||||||||
| NPI: | 1548656846 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAMBERT | ||||||||
| FirstName: | CLINTON | ||||||||
| MiddleName: | BOYD | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LAMFT, LAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 804 THOMAS ST | ||||||||
| Address2: | |||||||||
| City: | PARAGOULD | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724505640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8705656095 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 809 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | TRUMANN | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724722611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8704830068 | ||||||||
| FaxNumber: | 8704830066 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2015 | ||||||||
| LastUpdateDate: | 04/13/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | A1501004 | AR | N | Behavioral Health & Social Service Providers | Counselor | 106H00000X | F1501003 | AR | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.