Healthcare Provider Details

I. General information

NPI: 1043393143
Provider Name (Legal Business Name): BRUCE ELLIOTT HAMMOND L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2008 BREMO RD SUITE 105
RICHMOND VA
23226-2443
US

IV. Provider business mailing address

507 BELLE GROVE LN
RICHMOND VA
23229-7256
US

V. Phone/Fax

Practice location:
  • Phone: 804-673-0100
  • Fax: 804-673-0100
Mailing address:
  • Phone: 804-282-5918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904002207
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: