Provider Demographics
NPI:1245399062
Name:HAMMONTREE, DONNA M (LCSW)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:HAMMONTREE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:31406-1517
Mailing Address - Country:US
Mailing Address - Phone:912-234-2159
Mailing Address - Fax:912-691-5151
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:31406-1517
Practice Address - Country:US
Practice Address - Phone:912-234-2159
Practice Address - Fax:912-691-5151
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0027341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00941256AMedicaid
GA277701000OtherMAGELLAN
GA582617599OtherTIN