Provider Demographics
NPI:1639226509
Name:HAMMOND, JOHN WILKES II (LICSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:WILKES
Last Name:HAMMOND
Suffix:II
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 LONG POND RD
Mailing Address - Street 2:SUITE106
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2662
Mailing Address - Country:US
Mailing Address - Phone:508-747-6762
Mailing Address - Fax:508-747-1315
Practice Address - Street 1:118 LONG POND RD
Practice Address - Street 2:SUITE106
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2662
Practice Address - Country:US
Practice Address - Phone:508-747-6762
Practice Address - Fax:508-747-1315
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1025031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical