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General NPI Number Information
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NPI Number | 1942779491
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Entity Type | Individual
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Provider Name | MICHAEL STEPHEN HAMLIN LMSW-C
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Gender | Male
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Dates
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Enumeration Date | 11/14/2018
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Last Update Date | 11/14/2018
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Provider Practice Location Address
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Address Line | 2206 N JOHN REDDITT DR
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City | LUFKIN
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State | TX
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Zip | 75904-1776
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Country | US
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Telephone | 504-220-7493
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Fax |
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Provider Business Mailing Address
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Address Line | 1028 BERRY AVE APT 201
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City | TOMAH
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State | WI
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Zip | 54660-3403
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Country | US
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Telephone | 504-220-7493
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801098840
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License Number State | MI
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