Provider Demographics
NPI:1013163898
Name:HAMM, MARK ANTHONY (NCC, LPCC)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:ANTHONY
Last Name:HAMM
Suffix:
Gender:M
Credentials:NCC, LPCC
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 2
Mailing Address - Street 2:201 EAST MT. VERNON STREET
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42502-0002
Mailing Address - Country:US
Mailing Address - Phone:606-451-9379
Mailing Address - Fax:606-451-8149
Practice Address - Street 1:201 E MOUNT VERNON ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-1412
Practice Address - Country:US
Practice Address - Phone:606-451-9379
Practice Address - Fax:606-451-8149
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0971101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional