Provider Demographics
NPI:1558370718
Name:ELLEN C. HAMILTON
Entity Type:Organization
Organization Name:ELLEN C. HAMILTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:CECELIA
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:972-731-0756
Mailing Address - Street 1:12207 RIDGETOP CIR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-4991
Mailing Address - Country:US
Mailing Address - Phone:972-713-0756
Mailing Address - Fax:972-713-0756
Practice Address - Street 1:720 E MAIN ST STE C-7
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-3105
Practice Address - Country:US
Practice Address - Phone:469-867-3274
Practice Address - Fax:972-731-0756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13079101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0955205-2Medicaid
TX125811OtherVAUE OPTIONS