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General NPI Number Information
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NPI Number | 1962001131
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Entity Type | Individual
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Provider Name | STEPHEN ISAAC HAMILTON
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Gender | Male
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Dates
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Enumeration Date | 10/20/2020
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 333 S MADISON ST
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City | MUNCIE
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State | IN
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Zip | 47305-2465
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Country | US
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Telephone | 765-286-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 11881 S COUNTY ROAD 50 W
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City | MUNCIE
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State | IN
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Zip | 47302-9472
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Country | US
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Telephone | 813-390-0712
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 88002486A
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License Number State | IN
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