Provider Demographics
NPI:1154585792
Name:HAMM, PAULA JEAN (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:JEAN
Last Name:HAMM
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6665 OLD DOMINION DR
Mailing Address - Street 2:B-3RD FLOOR
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-4518
Mailing Address - Country:US
Mailing Address - Phone:703-356-5829
Mailing Address - Fax:703-356-5829
Practice Address - Street 1:6665 OLD DOMINION DR
Practice Address - Street 2:B-3RD FLOOR
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-4518
Practice Address - Country:US
Practice Address - Phone:703-356-5829
Practice Address - Fax:703-356-5829
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001434171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator