MEDICARE: MR. WILLIAM F HAMILTON LISWS

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	101YM0800X	Mental Health Counselor	I005216	OH

General Provider Information

NPI Number	:	1346349198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM F HAMILTON LISWS

Provider Business Mailing Address
First Line	:	2770 SOM CENTER RD
Second Line	:	SUITE 2
City	:	WILLOUGHBY
State	:	OH
Zip	:	44094-9111
Country	:	US
Telephone Number	:	440-516-1350
Fax Number	:	440-944-7330

Provider Business Practice Location Address
First Line	:	2770 SOM CENTER RD
Second Line	:	SUITE 2
City	:	WILLOUGHBY
State	:	OH
Zip	:	44094-9111
Country	:	US
Telephone Number	:	440-516-1350
Fax Number	:	440-944-7330

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

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	01/05/2011

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