Provider Demographics
NPI:1497307615
Name:HAMILTON, JAMES ANDREW III
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ANDREW
Last Name:HAMILTON
Suffix:III
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 1:3830 VERRET ST
Mailing Address - Street 2:
Mailing Address - City:SAINT BERNARD
Mailing Address - State:LA
Mailing Address - Zip Code:70085-4534
Mailing Address - Country:US
Mailing Address - Phone:504-905-8365
Mailing Address - Fax:504-682-3034
Practice Address - Street 1:3830 VERRET ST
Practice Address - Street 2:
Practice Address - City:SAINT BERNARD
Practice Address - State:LA
Practice Address - Zip Code:70085-4534
Practice Address - Country:US
Practice Address - Phone:504-905-8365
Practice Address - Fax:504-682-3034
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA007657406103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation