Healthcare Provider Details

I. General information

NPI: 1790164200
Provider Name (Legal Business Name): HILLARY HAMM VANN LPC,RPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2015
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10150 MALLARD CREEK RD STE 509
CHARLOTTE NC
28262-9708
US

IV. Provider business mailing address

10150 MALLARD CREEK RD STE 509
CHARLOTTE NC
28262-9708
US

V. Phone/Fax

Practice location:
  • Phone: 980-308-4500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8986
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8986
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: