Provider Demographics
NPI:1447880018
Name:HEMMER, MICHELLE (LCSW, CCTP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:HEMMER
Suffix:
Gender:F
Credentials:LCSW, CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47542-9792
Mailing Address - Country:US
Mailing Address - Phone:762-359-6070
Mailing Address - Fax:
Practice Address - Street 1:671 3RD AVE STE G
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-3653
Practice Address - Country:US
Practice Address - Phone:762-359-6070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN3401196A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical