Provider Demographics
NPI:1669255253
Name:HAMM, JEFFREY L (MSW)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:L
Last Name:HAMM
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 JENIFER ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-3716
Mailing Address - Country:US
Mailing Address - Phone:608-335-4002
Mailing Address - Fax:
Practice Address - Street 1:660 W WASHINGTON AVE STE 310
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-4703
Practice Address - Country:US
Practice Address - Phone:608-335-4002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI131934-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker