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General NPI Number Information
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NPI Number | 1518220987
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Entity Type | Individual
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Provider Name | SEAN HAMMER M.A., LPC
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Gender | Male
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Dates
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Enumeration Date | 06/20/2012
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Last Update Date | 06/15/2015
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Provider Practice Location Address
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Address Line | 378 FALLS AVE
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City | TWIN FALLS
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State | ID
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Zip | 83301-3373
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Country | US
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Telephone | 208-293-8062
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Fax |
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Provider Business Mailing Address
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Address Line | 1709 DORA DR N
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City | TWIN FALLS
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State | ID
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Zip | 83301-4252
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Country | US
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Telephone | 208-539-6791
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC-4973
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-4973
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License Number State | ID
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