Provider Demographics
NPI:1558677435
Name:HAMMON, ERIC (LPC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:HAMMON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3243 W 6960 S
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-1750
Mailing Address - Country:US
Mailing Address - Phone:801-839-4044
Mailing Address - Fax:801-840-5485
Practice Address - Street 1:3243 W 6960 S
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-1750
Practice Address - Country:US
Practice Address - Phone:801-839-4044
Practice Address - Fax:801-840-5485
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4831438-6004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional