Healthcare Provider Details

I. General information

NPI: 1356118814
Provider Name (Legal Business Name): NOAH HAMILTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2023
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 E 100 S
SALT LAKE CITY UT
84111-1700
US

IV. Provider business mailing address

344 E 100 S
SALT LAKE CITY UT
84111-1700
US

V. Phone/Fax

Practice location:
  • Phone: 801-428-4257
  • Fax:
Mailing address:
  • Phone: 801-428-4257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14290646-3502
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: