Healthcare Provider Details

I. General information

NPI: 1104981364
Provider Name (Legal Business Name): DEAN E HAMMER PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 05/31/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 HEARTHSTONE LANE
SOUTH LONDONDERRY VT
05155-9615
US

IV. Provider business mailing address

49 JEWELL BROOK FARM RD
LUDLOW VT
05149-9502
US

V. Phone/Fax

Practice location:
  • Phone: 802-228-4564
  • Fax:
Mailing address:
  • Phone: 802-228-4564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number048-0000896
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number048-0000896
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number048-0000896
License Number StateVT
# 4
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number048-0000896
License Number StateVT
# 5
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number048-0000896
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: