Provider Demographics
NPI:1477758878
Name:HAMMONS, MARY FAYE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:FAYE
Last Name:HAMMONS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4110 KALB CT SW
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-4446
Mailing Address - Country:US
Mailing Address - Phone:404-541-3014
Mailing Address - Fax:678-556-1974
Practice Address - Street 1:2300 LAKE PARK DR SE
Practice Address - Street 2:SUITE 100
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4076
Practice Address - Country:US
Practice Address - Phone:404-541-3014
Practice Address - Fax:678-556-1974
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA13021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical