Healthcare Provider Details

I. General information

NPI: 1225014400
Provider Name (Legal Business Name): MINDY L HAMILTON MSW, LCSW, RPT-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1093 HOWELL RD.
PURVIS MS
39475
US

IV. Provider business mailing address

1091 HOWELL RD
PURVIS MS
39475-5827
US

V. Phone/Fax

Practice location:
  • Phone: 601-466-0462
  • Fax:
Mailing address:
  • Phone: 601-466-0462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC6325
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: