Provider Demographics
NPI:1487815437
Name:HAMILTON-LOCKWOOD, SHANA VALERE (PHD)
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:VALERE
Last Name:HAMILTON-LOCKWOOD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 W SUMMIT HILL DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37902-1025
Mailing Address - Country:US
Mailing Address - Phone:865-525-1099
Mailing Address - Fax:865-525-7494
Practice Address - Street 1:108 W SUMMIT HILL DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37902-1025
Practice Address - Country:US
Practice Address - Phone:865-525-1099
Practice Address - Fax:865-525-7494
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP2839103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling