Provider Demographics
NPI:1780449587
Name:HAMMERSLOUGH, INDIA HAAS (LCMHC)
Entity type:Individual
Prefix:
First Name:INDIA
Middle Name:HAAS
Last Name:HAMMERSLOUGH
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MILL ST STE 312
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1523
Mailing Address - Country:US
Mailing Address - Phone:802-528-1780
Mailing Address - Fax:
Practice Address - Street 1:1 MILL ST STE 312
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1523
Practice Address - Country:US
Practice Address - Phone:802-528-1780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0135739101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health