Provider Demographics
NPI:1346712510
Name:HAMILTON, MARK
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 SOUTHPARK DR STE 300
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-5679
Mailing Address - Country:US
Mailing Address - Phone:303-909-8277
Mailing Address - Fax:
Practice Address - Street 1:621 SOUTHPARK DR STE 300
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-5679
Practice Address - Country:US
Practice Address - Phone:303-909-8277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0011808101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor