Provider Demographics
NPI:1578642112
Name:HAMRICK, CHRISTOPHER LANE (LMFT)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:LANE
Last Name:HAMRICK
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 VALPARAISO ST
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-3138
Mailing Address - Country:US
Mailing Address - Phone:219-477-5646
Mailing Address - Fax:219-728-4765
Practice Address - Street 1:2004 VALPARAISO ST
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-3138
Practice Address - Country:US
Practice Address - Phone:219-477-5646
Practice Address - Fax:219-728-4765
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001549A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist