Provider Demographics
NPI:1053857862
Name:HAMES, JEFF (CADC-II)
Entity Type:Individual
Prefix:MR
First Name:JEFF
Middle Name:
Last Name:HAMES
Suffix:
Gender:M
Credentials:CADC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 RUSSELL PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-7640
Mailing Address - Country:US
Mailing Address - Phone:478-225-9860
Mailing Address - Fax:478-225-9861
Practice Address - Street 1:607 RUSSELL PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-7640
Practice Address - Country:US
Practice Address - Phone:478-225-9860
Practice Address - Fax:478-225-9861
Is Sole Proprietor?:No
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA595101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)