Provider Demographics
NPI:1821542572
Name:HAMM, JACOB
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:
Last Name:HAMM
Suffix:
Gender:M
Credentials:
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 444
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-0444
Mailing Address - Country:US
Mailing Address - Phone:828-837-0071
Mailing Address - Fax:828-837-5309
Practice Address - Street 1:217 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ROBBINSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28771-8409
Practice Address - Country:US
Practice Address - Phone:828-479-6466
Practice Address - Fax:828-479-9267
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0109181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical