Provider Demographics
NPI:1619907847
Name:HAMMER, BETH G (LCSW)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:G
Last Name:HAMMER
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 1:707 ALEXANDER ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-2598
Mailing Address - Country:US
Mailing Address - Phone:609-987-8100
Mailing Address - Fax:609-987-0574
Practice Address - Street 1:707 ALEXANDER ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-2598
Practice Address - Country:US
Practice Address - Phone:609-987-8100
Practice Address - Fax:609-987-0574
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC00032200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0045608Medicaid
NJ0045608Medicaid