Provider Demographics
NPI:1093035057
Name:HAMILTON, AMY SUE (LCSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:SUE
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:PO BOX 541
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-0541
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 FUNDY RD
Practice Address - Street 2:SUITE 2
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1775
Practice Address - Country:US
Practice Address - Phone:207-232-1760
Practice Address - Fax:207-725-5777
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC74291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical