Individual provider Active NPI

Phyllis T Hammond, MSSW, LCSW

  • Clinical Social Worker
  • Canton, MS
National Provider Identifier
1639354418
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C1607 Issued in MS
Practice address
1171 Hart St
Canton, MS 39046-4805
Phone
(601) 859-9888
Fax
(601) 859-9004
NPI assigned
Dec 30, 2007
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C1607 MS Primary

Addresses

Primary practice location

1171 Hart St
Canton, MS 39046-4805

Mailing address

5440 Executive PL Ste B
Jackson, MS 39206-4145
Phone (601) 212-4856

Other practice location 1

5440 Executive Pl Ste B
Jackson, MS 39206-4145
Phone (601) 212-4856

Other identifiers 3

IdentifierTypeStateIssuer
1639354418OtherMSCENPATICO
000456093OtherMSOPTUM (UHC)
02632342MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171017003369 MS Practitioner - Clinical Social Worker 7719253830 Practice locations: Ridgeland, MS

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C1607MSMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1639354418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 EXECUTIVE PL STE B",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392064145",
            "telephone_number": "601-212-4856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 HART ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390464805",
            "telephone_number": "601-859-9888",
            "fax_number": "601-859-9004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5440 Executive Pl Ste B",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392064145",
            "country_code": "US",
            "telephone_number": "601-212-4856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMMOND",
        "first_name": "PHYLLIS",
        "middle_name": "T",
        "credential": "MSSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-30",
        "last_updated": "2026-09-29",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C1607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CENPATICO",
            "identifier": "1639354418",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM (UHC)",
            "identifier": "000456093",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02632342",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MS

Sources for this page

Verify at the official NPI Registry.