Provider Demographics
NPI:1043263429
Name:HAMM, CHRIS C (LCSW, ACSW)
Entity type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:C
Last Name:HAMM
Suffix:
Gender:M
Credentials:LCSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4825 OSSINGTON CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-4881
Mailing Address - Country:US
Mailing Address - Phone:317-329-0777
Mailing Address - Fax:317-272-3331
Practice Address - Street 1:6655 E US HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-8923
Practice Address - Country:US
Practice Address - Phone:317-272-3334
Practice Address - Fax:317-272-3331
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003714A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000188929OtherANTHEM BCBS PROVIDER PIN
IN344840MMMedicare PIN