Healthcare Provider Details

I. General information

NPI: 1841060753
Provider Name (Legal Business Name): HEATHER HELEN HAMILTON MHC-LP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 BROADWAY STE 1168
NEW YORK NY
10004-1326
US

IV. Provider business mailing address

336 SAINT MARKS AVE # 1B
BROOKLYN NY
11238-3604
US

V. Phone/Fax

Practice location:
  • Phone: 212-320-2216
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number014496
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: