Provider Demographics
NPI:1639983695
Name:HAMMONS, LISA (EDD, LPC-S)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:HAMMONS
Suffix:
Gender:F
Credentials:EDD, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6512 MARIPOSA LN
Mailing Address - Street 2:
Mailing Address - City:VANCLEAVE
Mailing Address - State:MS
Mailing Address - Zip Code:39565-8904
Mailing Address - Country:US
Mailing Address - Phone:228-627-0160
Mailing Address - Fax:
Practice Address - Street 1:6512 MARIPOSA LN
Practice Address - Street 2:
Practice Address - City:VANCLEAVE
Practice Address - State:MS
Practice Address - Zip Code:39565-8904
Practice Address - Country:US
Practice Address - Phone:228-627-0160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-01
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1708101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional