Provider Demographics
NPI:1528058948
Name:HAMMOND, RICHARD A (PHD, LPCC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:HAMMOND
Suffix:
Gender:M
Credentials:PHD, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 WINDHAM CT
Mailing Address - Street 2:SUITE 6
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-5060
Mailing Address - Country:US
Mailing Address - Phone:330-726-9642
Mailing Address - Fax:330-726-6785
Practice Address - Street 1:940 WINDHAM CT
Practice Address - Street 2:SUITE 6
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-5060
Practice Address - Country:US
Practice Address - Phone:330-726-9642
Practice Address - Fax:330-726-6785
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0000502101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCP20763OtherMEDICARE PTAN