Provider Demographics
NPI:1548415870
Name:HAMILTON, LORI M (LISW-S)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:M
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2281
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44504-0281
Mailing Address - Country:US
Mailing Address - Phone:330-519-7543
Mailing Address - Fax:
Practice Address - Street 1:1601 MOTOR INN DR STE 215
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:OH
Practice Address - Zip Code:44420-2482
Practice Address - Country:US
Practice Address - Phone:330-519-7543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.10003911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0341887Medicaid