Provider Demographics
NPI:1134365984
Name:HEMMER, PEGGY ANN SERENA (LCSW, LISW-S)
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:ANN SERENA
Last Name:HEMMER
Suffix:
Gender:F
Credentials:LCSW, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4624 SAWMILL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2247
Mailing Address - Country:US
Mailing Address - Phone:614-459-4490
Mailing Address - Fax:614-457-3656
Practice Address - Street 1:2525 PASADENA AVE S STE M
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-4556
Practice Address - Country:US
Practice Address - Phone:727-776-0510
Practice Address - Fax:668-860-0133
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-29
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 0700333104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker