Healthcare Provider Details

I. General information

NPI: 1124841226
Provider Name (Legal Business Name): LAUREN JULIE HAMMETT M.A., C.A.S., NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2024
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2644 RIVA RD
ANNAPOLIS MD
21401-7427
US

IV. Provider business mailing address

6905 RAWHIDE RDG
COLUMBIA MD
21046-1326
US

V. Phone/Fax

Practice location:
  • Phone: 410-222-5000
  • Fax:
Mailing address:
  • Phone: 301-252-1348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberCER-126091-T3Q5D4
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: