Healthcare Provider Details

I. General information

NPI: 1497673040
Provider Name (Legal Business Name): KELSEY HAMILTON PHD, LMFT-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

3021 BERKS WAY STE 101
RALEIGH NC
27614-6775
US

IV. Provider business mailing address

4108 MANGROVE DR
RALEIGH NC
27616-8945
US

V. Phone/Fax

Practice location:
  • Phone: 919-285-4802
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number10705A
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: