Provider Demographics
NPI:1760719264
Name:HAMMOND, DEBORAH PINKETT (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:PINKETT
Last Name:HAMMOND
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 1:4800 S CHICAGO BEACH DR
Mailing Address - Street 2:512N
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-7032
Mailing Address - Country:US
Mailing Address - Phone:312-622-0446
Mailing Address - Fax:
Practice Address - Street 1:10105 S WALLACE ST
Practice Address - Street 2:2ND FLR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60628-1841
Practice Address - Country:US
Practice Address - Phone:312-622-0446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490107231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical