Individual provider Active NPI

Stacey Nicole Lambour, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • South Riding, VA
National Provider Identifier
1386059988
Registry record updated Jul 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024171782 Issued in VA
Practice address
43130 Amberwood PLZ
140
South Riding, VA 20152-4105
Phone
(703) 348-0030
NPI assigned
Jun 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024171782 VA Primary

Addresses

Primary practice location

43130 Amberwood PLZ
140
South Riding, VA 20152-4105

Mailing address

43130 Amberwood PLZ
140
South Riding, VA 20152-4105
Phone (703) 348-0030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Dec 2, 2015 through Dec 2, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0024171782VAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404604800000",
    "number": "1386059988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43130 AMBERWOOD PLZ",
            "address_2": "140",
            "city": "SOUTH RIDING",
            "state": "VA",
            "postal_code": "201524105",
            "telephone_number": "703-348-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43130 AMBERWOOD PLZ",
            "address_2": "140",
            "city": "SOUTH RIDING",
            "state": "VA",
            "postal_code": "201524105",
            "telephone_number": "703-348-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMBOUR",
        "first_name": "STACEY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024171782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Riding, VA

Sources for this page

Verify at the official NPI Registry.