MEDICARE: JUDITH L HAMILTON MSW

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	104100000X	Social Worker	4147	GA
2	1041C0700X	Clinical Social Worker	6542	GA

General Provider Information

NPI Number	:	1912179284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH L HAMILTON MSW

Provider Business Mailing Address
First Line	:	596 KERSHAW DR
Second Line	:
City	:	NORTH AUGUSTA
State	:	SC
Zip	:	29841-2734
Country	:	US
Telephone Number	:	803-917-3558
Fax Number	:

Provider Business Practice Location Address
First Line	:	596 KERSHAW DR
Second Line	:
City	:	NORTH AUGUSTA
State	:	SC
Zip	:	29841-2734
Country	:	US
Telephone Number	:	803-917-3558
Fax Number	:

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

Provider Enumeration Date	:	03/27/2008
Last Update Date	:	01/22/2019

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