Basic Information
Provider Information
NPI: 1912392028
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMMETT
FirstName: CHRISTEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HENSON
OtherFirstName: CHRISTEL
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 2215 LANGHORNE RD
Address2:  
City: LYNCHBURG
State: VA
PostalCode: 245011121
CountryCode: US
TelephoneNumber: 4349484831
FaxNumber:  
Practice Location
Address1: 620 COURT ST
Address2:  
City: LYNCHBURG
State: VA
PostalCode: 245041312
CountryCode: US
TelephoneNumber: 4349484831
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/06/2015
LastUpdateDate: 04/06/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X0701006113VAY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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