Provider Demographics
NPI:1558638015
Name:HAMILTON, DONALD WAYNE (LMHC)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:WAYNE
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 MOON ST. NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-2853
Mailing Address - Country:US
Mailing Address - Phone:505-271-2490
Mailing Address - Fax:505-271-2490
Practice Address - Street 1:1900 MOON ST. NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-2853
Practice Address - Country:US
Practice Address - Phone:505-271-2490
Practice Address - Fax:505-271-2490
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0138681101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional