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NPI Code Detail

MEDICARE: AMY HAMILTON

MEDICARE: AMY 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
1251S00000XCommunity/Behavioral Health AgencyLPC004110GA

General Provider Information

NPI Number : 1730337643
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMY HAMILTON
Provider Business Mailing Address
First Line : 4255 WADE GREEN RD NW
Second Line : SUITE 414
City : KENNESAW
State : GA
Zip : 30144-1762
Country : US
Telephone Number : 678-213-2194
Fax Number : 678-213-2215
Provider Business Practice Location Address
First Line : 4255 WADE GREEN RD NW
Second Line : SUITE 414
City : KENNESAW
State : GA
Zip : 30144-1762
Country : US
Telephone Number : 678-213-2194
Fax Number : 678-213-2215
Authorized Official
Title or Position : CLINICAL COORDINATOR
Name : DR. AMY L HAMILTON
Credential : PSYD, LPC
Telephone Number : 404-973-5602
Provider Enumeration Date : 09/04/2008
Last Update Date : 12/19/2012

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