Provider Demographics
NPI:1750016820
Name:DESSIE KAMMER LLC
Entity type:Organization
Organization Name:DESSIE KAMMER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DESSIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-670-0900
Mailing Address - Street 1:2646 HIGHWAY AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-1661
Mailing Address - Country:US
Mailing Address - Phone:219-670-0900
Mailing Address - Fax:
Practice Address - Street 1:2646 HIGHWAY AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-1661
Practice Address - Country:US
Practice Address - Phone:219-670-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-21
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty