Provider Demographics
NPI:1942454293
Name:HAMMACK, JULIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:HAMMACK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:EGGEBRAATEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:760 E WARM SPRINGS AVE STE D
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-6459
Mailing Address - Country:US
Mailing Address - Phone:208-793-5631
Mailing Address - Fax:208-225-4995
Practice Address - Street 1:760 E WARM SPRINGS AVE STE D
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83712-6459
Practice Address - Country:US
Practice Address - Phone:208-793-5631
Practice Address - Fax:208-225-4995
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2022-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-310711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical