Provider Demographics
NPI:1295782191
Name:HAMM, NANCY (LSCSW)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:HAMM
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:DREILING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSCSW
Mailing Address - Street 1:635 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-3602
Mailing Address - Country:US
Mailing Address - Phone:316-660-7600
Mailing Address - Fax:316-383-7925
Practice Address - Street 1:1919 N AMIDON AVE
Practice Address - Street 2:STE. 130
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-2117
Practice Address - Country:US
Practice Address - Phone:316-660-7675
Practice Address - Fax:316-832-1571
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS22991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS7155OtherPREFERRED HEALTH SYSTEMS
KSP00050934OtherRAILROAD MEDICARE
KS069861OtherBLUE CROSS
KS069861Medicare ID - Type Unspecified
KSP70572Medicare UPIN