Provider Demographics
NPI:1346349198
Name:HAMILTON, WILLIAM F (LISWS)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:F
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:LISWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2770 SOM CENTER RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-9111
Mailing Address - Country:US
Mailing Address - Phone:440-516-1350
Mailing Address - Fax:440-944-7330
Practice Address - Street 1:2770 SOM CENTER RD
Practice Address - Street 2:SUITE 2
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-9111
Practice Address - Country:US
Practice Address - Phone:440-516-1350
Practice Address - Fax:440-944-7330
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI005216101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW09922Medicare ID - Type Unspecified