Provider Demographics
NPI:1477644243
Name:HAMILTON, KRISTIN L (LPC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:L
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7326 CAPTIVA DR
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-8842
Mailing Address - Country:US
Mailing Address - Phone:517-703-0349
Mailing Address - Fax:517-622-1242
Practice Address - Street 1:1035 CHARLEVOIX DR
Practice Address - Street 2:SUITE 100
Practice Address - City:GRAND LEDGE
Practice Address - State:MI
Practice Address - Zip Code:48837-2223
Practice Address - Country:US
Practice Address - Phone:517-627-2181
Practice Address - Fax:517-622-1242
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007574101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1715928Medicaid