Provider Demographics
NPI:1467101618
Name:LAMP-O'MEARA, LAURA LYNETTE (CDCA)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNETTE
Last Name:LAMP-O'MEARA
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 PIKE ST
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-3522
Mailing Address - Country:US
Mailing Address - Phone:304-239-5355
Mailing Address - Fax:
Practice Address - Street 1:1017 PIKE ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3522
Practice Address - Country:US
Practice Address - Phone:740-371-7007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-23
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.188048101YA0400X
OHAPS.002198175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist