Provider Demographics
NPI:1679143176
Name:HAMMUDEH, HANNAH MARIA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:MARIA
Last Name:HAMMUDEH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:MARIA
Other - Last Name:HAMMUDEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PEROTTI
Mailing Address - Street 1:3307 CALDWELL BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-6403
Mailing Address - Country:US
Mailing Address - Phone:208-465-4833
Mailing Address - Fax:
Practice Address - Street 1:3307 CALDWELL BLVD STE 104
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-6403
Practice Address - Country:US
Practice Address - Phone:208-465-4833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID88616171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical