Provider Demographics
NPI:1629135496
Name:HAMMONTREE, SCOTT (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:HAMMONTREE
Suffix:
Gender:M
Credentials:MA, LPC
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 550178
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28055-0178
Mailing Address - Country:US
Mailing Address - Phone:704-861-2234
Mailing Address - Fax:704-861-2235
Practice Address - Street 1:227 WILMOT DR
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-4048
Practice Address - Country:US
Practice Address - Phone:704-861-2234
Practice Address - Fax:704-861-2235
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC938101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102411Medicaid