Provider Demographics
NPI:1306884895
Name:HAMRICK, TERRE LYNNE (LCSW;LADC;CEAP)
Entity type:Individual
Prefix:
First Name:TERRE
Middle Name:LYNNE
Last Name:HAMRICK
Suffix:
Gender:F
Credentials:LCSW;LADC;CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4127 PLEASANT RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-1916
Mailing Address - Country:US
Mailing Address - Phone:702-648-1530
Mailing Address - Fax:
Practice Address - Street 1:6735 W CHARLESTON BLVD
Practice Address - Street 2:A-100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-9207
Practice Address - Country:US
Practice Address - Phone:702-253-0818
Practice Address - Fax:702-253-9625
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100508023Medicaid