1730102401 NPI number — MS. MELISSA K HAMM PSYD

Table of content: MS. MELISSA K HAMM PSYD (NPI 1730102401)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730102401 NPI number — MS. MELISSA K HAMM PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAMM
Provider First Name:
MELISSA
Provider Middle Name:
K
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730102401
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/23/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 444
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MURPHY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28906-0444
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-837-0071
Provider Business Mailing Address Fax Number:
828-837-5309

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
91 TIMBERLANE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAYNESVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28786-7927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-454-1098
Provider Business Practice Location Address Fax Number:
877-346-1089
Provider Enumeration Date:
07/25/2006

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: 103TC0700X , with the licence number:  3224 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 6107324 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1399K . This is a "BCBSNC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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