Provider Demographics
NPI:1053480889
Name:HAM, PETER (LMHC)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:HAM
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 WINDCHIME DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-2934
Mailing Address - Country:US
Mailing Address - Phone:508-337-8687
Mailing Address - Fax:508-999-6607
Practice Address - Street 1:466 COUNTY ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-5107
Practice Address - Country:US
Practice Address - Phone:508-997-0794
Practice Address - Fax:508-999-6607
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1287101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health