MEDICARE: DR. LORIE ANN HAMEL PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	630100914	MI
2	103TC0700X	Clinical Psychologist	6301009414	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	680A112130	OTHER	MI	GROUP PIN

General Provider Information

NPI Number	:	1285767095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORIE ANN HAMEL PH.D.

Provider Business Mailing Address
First Line	:	9045 US HIGHWAY 31 STE A
Second Line	:
City	:	BERRIEN SPRINGS
State	:	MI
Zip	:	49104-0001
Country	:	US
Telephone Number	:	269-473-2222
Fax Number	:	269-473-6880

Provider Business Practice Location Address
First Line	:	9045 US 31
Second Line	:
City	:	BERRIEN SPRINGS
State	:	MI
Zip	:	49103
Country	:	US
Telephone Number	:	269-473-2223
Fax Number	:	269-473-6880

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	02/17/2025

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