Provider Demographics
NPI:1851132401
Name:HACKMAN, LAWRENCE (LMFTA)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:HACKMAN
Suffix:
Gender:M
Credentials:LMFTA
Other - Prefix:
Other - First Name:LARRY
Other - Middle Name:
Other - Last Name:HACKMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3842 REDEMPTION AVE SE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-5700
Mailing Address - Country:US
Mailing Address - Phone:423-298-3998
Mailing Address - Fax:
Practice Address - Street 1:5800 SOUNDVIEW DR BLDG B
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-2000
Practice Address - Country:US
Practice Address - Phone:423-298-3998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMFTA.MG.61539898106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist