Provider Demographics
NPI:1568653731
Name:HAMANN, AMY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:HAMANN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:PARK HILLS
Mailing Address - State:MO
Mailing Address - Zip Code:63601-0157
Mailing Address - Country:US
Mailing Address - Phone:573-431-7336
Mailing Address - Fax:
Practice Address - Street 1:2280 PIMVILLE RD
Practice Address - Street 2:
Practice Address - City:PARK HILLS
Practice Address - State:MO
Practice Address - Zip Code:63601-8146
Practice Address - Country:US
Practice Address - Phone:573-431-7336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20050298621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical