Healthcare Provider Details

I. General information

NPI: 1962839951
Provider Name (Legal Business Name): AMANDA HAMMOND LPC, CAADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMANDA OWEN

II. Dates (important events)

Enumeration Date: 10/04/2013
Last Update Date: 06/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 GARFIELD AVE
BATTLE CREEK MI
49037
US

IV. Provider business mailing address

155 GARFIELD AVE
BATTLE CREEK MI
49037-3407
US

V. Phone/Fax

Practice location:
  • Phone: 269-962-3768
  • Fax:
Mailing address:
  • Phone: 734-748-4829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401013090
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: