Provider Demographics
NPI:1104981364
Name:HAMMER, DEAN E (PSYD)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:E
Last Name:HAMMER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 JEWELL BROOK FARM RD
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:VT
Mailing Address - Zip Code:05149-9502
Mailing Address - Country:US
Mailing Address - Phone:802-228-4564
Mailing Address - Fax:
Practice Address - Street 1:17 HEARTHSTONE LANE
Practice Address - Street 2:
Practice Address - City:SOUTH LONDONDERRY
Practice Address - State:VT
Practice Address - Zip Code:05155-9615
Practice Address - Country:US
Practice Address - Phone:802-228-4564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT048-0000896103TA0400X, 103T00000X, 103TB0200X, 103TC1900X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT69789OtherBLUE CROSS
VT2340554OtherCIGNA
VT1013953Medicaid
VT69789OtherBLUE CROSS