Provider Demographics
NPI:1649803214
Name:HAMMOND, MICAH (LPCC)
Entity type:Individual
Prefix:
First Name:MICAH
Middle Name:
Last Name:HAMMOND
Suffix:
Gender:F
Credentials: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 808
Mailing Address - Street 2:
Mailing Address - City:FELTON
Mailing Address - State:CA
Mailing Address - Zip Code:95018-0808
Mailing Address - Country:US
Mailing Address - Phone:707-490-4434
Mailing Address - Fax:
Practice Address - Street 1:6630 HIGHWAY 9 STE 203
Practice Address - Street 2:
Practice Address - City:FELTON
Practice Address - State:CA
Practice Address - Zip Code:95018-9711
Practice Address - Country:US
Practice Address - Phone:831-854-7801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-21
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5193101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health