Healthcare Provider Details

I. General information

NPI: 1649103532
Provider Name (Legal Business Name): BENJAMIN HAMILTON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10845 HARNEY ST
OMAHA NE
68154-2637
US

IV. Provider business mailing address

2370 NE 4TH AVE
BOCA RATON FL
33431-7646
US

V. Phone/Fax

Practice location:
  • Phone: 402-916-9421
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14954
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: