Provider Demographics
NPI:1073529160
Name:HAMILTON, M DANIELLE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:M
Middle Name:DANIELLE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:998 CROOKED HILL RD BLDG 827TH
Mailing Address - Street 2:
Mailing Address - City:WEST BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-1019
Mailing Address - Country:US
Mailing Address - Phone:631-848-4086
Mailing Address - Fax:
Practice Address - Street 1:998 CROOKED HILL RD BLDG 827TH
Practice Address - Street 2:
Practice Address - City:WEST BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-1019
Practice Address - Country:US
Practice Address - Phone:631-848-4086
Practice Address - Fax:631-761-2244
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY065343-11041C0700X
NY0763721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical