Provider Demographics
NPI:1225316300
Name:HAMILTON, LAURA (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
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 1:325 SHARON PARK DR
Mailing Address - Street 2:#738
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-6805
Mailing Address - Country:US
Mailing Address - Phone:650-922-5000
Mailing Address - Fax:
Practice Address - Street 1:1150 UNIVERSITY DR
Practice Address - Street 2:SUITE 110
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4408
Practice Address - Country:US
Practice Address - Phone:650-922-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-24
Last Update Date:2011-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA247561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical