Provider Demographics
NPI:1518223221
Name:HAMM, BRANDI PAGE (LCHMC, LCAS)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:PAGE
Last Name:HAMM
Suffix:
Gender:F
Credentials:LCHMC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 EXECUTIVE PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1833
Mailing Address - Country:US
Mailing Address - Phone:704-939-1100
Mailing Address - Fax:704-939-1173
Practice Address - Street 1:1650 HWY 18 SOUTH
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NC
Practice Address - Zip Code:28675-8478
Practice Address - Country:US
Practice Address - Phone:336-372-4095
Practice Address - Fax:336-372-2722
Is Sole Proprietor?:No
Enumeration Date:2012-04-06
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3248A101YA0400X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)