Provider Demographics
NPI:1598573735
Name:LAMBERT, STEPHEN BRENT JR (SUDC)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:BRENT
Last Name:LAMBERT
Suffix:JR
Gender:M
Credentials:SUDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2563 E 90 S
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-6563
Mailing Address - Country:US
Mailing Address - Phone:619-547-3871
Mailing Address - Fax:
Practice Address - Street 1:2563 E 90 S
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-6563
Practice Address - Country:US
Practice Address - Phone:619-547-3871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11549979-6006101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)