MEDICARE: ELLEN C. HAMILTON

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	101YP2500X	Professional Counselor	13079	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	125811	OTHER	TX	VAUE OPTIONS

General Provider Information

NPI Number	:	1558370718
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELLEN C. HAMILTON

Provider Business Mailing Address
First Line	:	12207 RIDGETOP CIR
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-4991
Country	:	US
Telephone Number	:	972-713-0756
Fax Number	:	972-713-0756

Provider Business Practice Location Address
First Line	:	720 E MAIN ST STE C-7
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75002-3105
Country	:	US
Telephone Number	:	469-867-3274
Fax Number	:	972-731-0756

Authorized Official
Title or Position	:	PSYCHOTHERAPIST
Name	:	MS. ELLEN CECELIA HAMILTON
Credential	:	LPC
Telephone Number	:	972-731-0756

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	08/22/2020

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