1548431174 NPI number — MRS. AMBER FAITH HAMMONTREE MA LPC

Table of content: MRS. AMBER FAITH HAMMONTREE MA LPC (NPI 1548431174)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548431174 NPI number — MRS. AMBER FAITH HAMMONTREE MA LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAMMONTREE
Provider First Name:
AMBER
Provider Middle Name:
FAITH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MA LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SMITH
Provider Other First Name:
AMBER
Provider Other Middle Name:
FAITH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA LPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1548431174
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
310 PAPER TRAIL WAY, SUITE 103
Provider Second Line Business Mailing Address:
HARMONY COUNSELING SERVICES, PC
Provider Business Mailing Address City Name:
CANTON
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30115
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-616-7994
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
129 ROYAL OAKS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CANTON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30115-6587
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-761-3065
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/24/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  LPC005102 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: LPC005102 . This is a "PROFESSIONAL LICENSE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".




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