Provider Demographics
NPI:1457012536
Name:HAMILTON, WILLIAM (MED, LAC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:MED, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EDGEVIEW DR
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-4003
Mailing Address - Country:US
Mailing Address - Phone:908-246-1480
Mailing Address - Fax:
Practice Address - Street 1:1 EDGEVIEW DR
Practice Address - Street 2:SUITE 2B
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-4003
Practice Address - Country:US
Practice Address - Phone:908-246-1480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-01
Last Update Date:2022-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00529700101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ37AC00529700OtherLICENSED ASSOCIATE COUNSELOR