Provider Demographics
NPI:1396376414
Name:HAMMEN, MOLLY BARBARA (LMHC)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:BARBARA
Last Name:HAMMEN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 S WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:IA
Mailing Address - Zip Code:50630-1003
Mailing Address - Country:US
Mailing Address - Phone:563-237-5300
Mailing Address - Fax:
Practice Address - Street 1:602 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:IA
Practice Address - Zip Code:50630-1003
Practice Address - Country:US
Practice Address - Phone:563-237-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA092072101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health