Provider Demographics
NPI:1871283325
Name:HAMMON, SANDRA KATHLEEN (LMSW)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:KATHLEEN
Last Name:HAMMON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12329 STATE ROUTE 90
Mailing Address - Street 2:
Mailing Address - City:LOCKE
Mailing Address - State:NY
Mailing Address - Zip Code:13092-3316
Mailing Address - Country:US
Mailing Address - Phone:251-727-1950
Mailing Address - Fax:
Practice Address - Street 1:12329 STATE ROUTE 90
Practice Address - Street 2:
Practice Address - City:LOCKE
Practice Address - State:NY
Practice Address - Zip Code:13092-3316
Practice Address - Country:US
Practice Address - Phone:251-727-1950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY119094-01101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)