Provider Demographics
NPI:1174631279
Name:HAMMOND, KAREN L (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:L
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 E LAKE SHORE DR
Mailing Address - Street 2:SUITE 209
Mailing Address - City:DACATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62521
Mailing Address - Country:US
Mailing Address - Phone:217-428-0600
Mailing Address - Fax:217-423-6536
Practice Address - Street 1:1770 E LAKE SHORE DR
Practice Address - Street 2:SUITE 209
Practice Address - City:DACATUR
Practice Address - State:IL
Practice Address - Zip Code:62521
Practice Address - Country:US
Practice Address - Phone:217-428-0600
Practice Address - Fax:217-423-6536
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical