Individual
PHYLLIS T HAMMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSSW, LCSW
Contact information
Practice address
1171 HART ST, CANTON, MS 39046-4805
(601) 859-9888
(601) 859-9004
Mailing address
5440 EXECUTIVE PL STE B, JACKSON, MS 39206-4145
(601) 212-4856
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C1607
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000456093
OPTUM (UHC)
MS
05
—
02632342
—
MS
01
—
1639354418
CENPATICO
MS
Enumeration date
12/30/2007
Last updated
04/22/2022
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