Provider Demographics
NPI:1831786920
Name:HAMMEL PSYCHOLOGICAL SERVICES, LLC
Entity type:Organization
Organization Name:HAMMEL PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:HAMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:205-336-1098
Mailing Address - Street 1:1760 S RAMSEY DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-7179
Mailing Address - Country:US
Mailing Address - Phone:205-336-1098
Mailing Address - Fax:
Practice Address - Street 1:1760 S RAMSEY DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-7179
Practice Address - Country:US
Practice Address - Phone:205-336-1098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-23
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty