Provider Demographics
NPI:1831382035
Name:HAMM, TINA M (NCC, LPCC)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:M
Last Name:HAMM
Suffix:
Gender:F
Credentials:NCC, 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 2
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42502-0002
Mailing Address - Country:US
Mailing Address - Phone:606-451-9379
Mailing Address - Fax:606-451-8149
Practice Address - Street 1:201 E MOUNT VERNON ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-1412
Practice Address - Country:US
Practice Address - Phone:606-451-9379
Practice Address - Fax:606-451-8149
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0915101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health