Provider Demographics
NPI:1285714063
Name:HAMMAKER, BRIDGITTE RENAE (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:BRIDGITTE
Middle Name:RENAE
Last Name:HAMMAKER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 KATHERYNE VILLAGE SQ
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21409-4296
Mailing Address - Country:US
Mailing Address - Phone:443-286-6592
Mailing Address - Fax:
Practice Address - Street 1:692 RITCHIE HIGHWAY
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146
Practice Address - Country:US
Practice Address - Phone:443-286-6592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD095501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDUB92Medicare UPIN
MH194RMedicare ID - Type UnspecifiedMEDICARE
MDPVPB126602Medicare UPIN
MDQE95Medicare UPIN
MD148247Medicare UPIN
MDW1360001Medicare UPIN