Provider Demographics
NPI:1639415565
Name:SHANA V. HAMILTON-LOCKWOOD, PH.D., P.L.L.C.
Entity Type:Organization
Organization Name:SHANA V. HAMILTON-LOCKWOOD, PH.D., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANA
Authorized Official - Middle Name:VALERE
Authorized Official - Last Name:HAMILTON-LOCKWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:865-525-1099
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-21
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP2839103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty