Provider Demographics
NPI:1073905071
Name:DONNA M HAMMONTREE, LCSW, LLC
Entity Type:Organization
Organization Name:DONNA M HAMMONTREE, LCSW, LLC
Other - Org Name:DONNA M HAMMONTREE, LCSW, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:MCNEELY
Authorized Official - Last Name:HAMMONTREE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:912-655-6521
Mailing Address - Street 1:7002 HODGSON MEMORIAL DR STE 103
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2586
Mailing Address - Country:US
Mailing Address - Phone:912-655-6521
Mailing Address - Fax:
Practice Address - Street 1:7002 HODGSON MEMORIAL DR STE 103
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2586
Practice Address - Country:US
Practice Address - Phone:912-655-6521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-27
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0027341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00941256BMedicaid
GA00941256AMedicaid
GA00941256AMedicaid