Organization Active NPI

Eric Hedean Lamb, LCSW, LLC

  • Clinical Social Worker
  • Miramar Beach, FL
National Provider Identifier
1437673969
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW12114 Issued in FL
Legal business name
ERIC HEDEAN LAMB, LCSW, LLC
Practice address
495 Grand Blvd Ste 206
Miramar Beach, FL 32550-1897
Phone
(847) 404-4855
Fax
(850) 613-6184
NPI assigned
Jul 26, 2017
Last updated
Mar 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Authorized official

Name
Eric H Lamb, LCSWNPI 1386643278
Title
President
Phone
(847) 404-4855

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW12114 FL Primary

Addresses

Primary practice location

495 Grand Blvd Ste 206
Miramar Beach, FL 32550-1897

Mailing address

495 Grand Blvd Ste 206
Miramar Beach, FL 32550-1897
Phone (847) 404-4855

Other identifiers 1

IdentifierTypeStateIssuer
022552800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171114002231 FL Part B Supplier - Clinic/Group Practice 4880950419 Receives reassigned benefits from 1 practitioner
Practice locations: Miramar Beach, FL

National Provider Directory

National Provider Directory

Locations

101 Matthew Blvd
Destin, FL 32541
Phone (847) 404-4855

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1437673969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 GRAND BLVD STE 206",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325501897",
            "telephone_number": "847-404-4855",
            "fax_number": "850-613-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 GRAND BLVD STE 206",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325501897",
            "telephone_number": "847-404-4855",
            "fax_number": "850-613-6184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC HEDEAN LAMB, LCSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-26",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "LAMB",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-404-4855",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022552800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.