Provider Demographics
NPI:1407192016
Name:HARVEY DARNELL HAMM
Entity Type:Organization
Organization Name:HARVEY DARNELL HAMM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:DARNELL
Authorized Official - Last Name:HAMM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C, LICSW
Authorized Official - Phone:240-601-9963
Mailing Address - Street 1:14706 HAWLEY LN
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-8949
Mailing Address - Country:US
Mailing Address - Phone:240-601-9963
Mailing Address - Fax:
Practice Address - Street 1:4900 ARENA DR.
Practice Address - Street 2:SUITE 460-E
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-8949
Practice Address - Country:US
Practice Address - Phone:240-601-9963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-31
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD132471041C0700X
DCLC500783701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty