Provider Demographics
NPI:1053064220
Name:HAMILTON, KRISTI DAWN (LPCA)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:DAWN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 LUNDY BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:BARBOURVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40906-7611
Mailing Address - Country:US
Mailing Address - Phone:606-261-6312
Mailing Address - Fax:
Practice Address - Street 1:142 BLACK ST
Practice Address - Street 2:
Practice Address - City:BARBOURVILLE
Practice Address - State:KY
Practice Address - Zip Code:40906-1483
Practice Address - Country:US
Practice Address - Phone:606-219-4676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY275453101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health