Provider Demographics
NPI:1417079559
Name:HAMILTON, NANCY (MSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-2827
Mailing Address - Country:US
Mailing Address - Phone:517-484-2736
Mailing Address - Fax:517-484-0396
Practice Address - Street 1:1800 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-2827
Practice Address - Country:US
Practice Address - Phone:517-484-2736
Practice Address - Fax:517-484-0396
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010210101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ON15620Medicare ID - Type Unspecified