Provider Demographics
NPI:1033455563
Name:HAMMOND, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 E FIFTH ST
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:SC
Mailing Address - Zip Code:29160-9702
Mailing Address - Country:US
Mailing Address - Phone:803-568-1000
Mailing Address - Fax:803-568-1081
Practice Address - Street 1:801 N HAMILTON ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:SC
Practice Address - Zip Code:29697-1061
Practice Address - Country:US
Practice Address - Phone:864-847-7344
Practice Address - Fax:864-847-3543
Is Sole Proprietor?:No
Enumeration Date:2013-01-03
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4612103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4612OtherBOARD OF EXAMINERS FOR COUNSELORS, THERAPISTS, & PSYCHO-EDUCATIONAL SPECIALISTS