Healthcare Provider Details

I. General information

NPI: 1922471614
Provider Name (Legal Business Name): CHARLES DION HAMEL LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2015
Last Update Date: 11/09/2021
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 SIERRA DR SE STE 10
ALBUQUERQUE NM
87108-5633
US

IV. Provider business mailing address

PO BOX 25884
ALBUQUERQUE NM
87125-0884
US

V. Phone/Fax

Practice location:
  • Phone: 505-600-2243
  • Fax: 866-530-3317
Mailing address:
  • Phone: 505-884-4464
  • Fax: 505-884-0054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberX-09339
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: