Provider Demographics
NPI:1164052007
Name:HAMILTON, MADELYN G (MS, LAC)
Entity Type:Individual
Prefix:MRS
First Name:MADELYN
Middle Name:G
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 N KATHRYN LN
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-5165
Mailing Address - Country:US
Mailing Address - Phone:618-367-0351
Mailing Address - Fax:
Practice Address - Street 1:2200 N KATHRYN LN
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-5165
Practice Address - Country:US
Practice Address - Phone:618-367-0351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-20
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA2302016101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor