Healthcare Provider Details

I. General information

NPI: 1295204592
Provider Name (Legal Business Name): RACHEL ANNE HAMMANN LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2018
Last Update Date: 04/19/2024
Certification Date: 04/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 CONCORD PKWY S
CONCORD NC
28027-6730
US

IV. Provider business mailing address

280 CONCORD PKWY S
CONCORD NC
28027-6730
US

V. Phone/Fax

Practice location:
  • Phone: 980-209-6328
  • Fax:
Mailing address:
  • Phone: 980-209-6328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2203934
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC016803
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: