Healthcare Provider Details

I. General information

NPI: 1750213948
Provider Name (Legal Business Name): STANLEY HAMILTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 A TEXAS AVENUE STUDENT UNION ANNEX
HAMMOND LA
70402-0001
US

IV. Provider business mailing address

PO BOX 2641
HAMMOND LA
70404-2641
US

V. Phone/Fax

Practice location:
  • Phone: 985-549-3894
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number11253
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: