Provider Demographics
NPI:1396792230
Name:HAMBAUGH, WILLIAM (LPC MHSP NCC)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:HAMBAUGH
Suffix:
Gender:M
Credentials:LPC MHSP NCC
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 867
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37371-0867
Mailing Address - Country:US
Mailing Address - Phone:423-744-8734
Mailing Address - Fax:423-649-0386
Practice Address - Street 1:748 TELL STREET
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303
Practice Address - Country:US
Practice Address - Phone:423-744-8734
Practice Address - Fax:423-649-0346
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
TN0799101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health