Provider Demographics
NPI:1689096869
Name:HAMLETT, AMY PRIDGEN (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:PRIDGEN
Last Name:HAMLETT
Suffix:
Gender:F
Credentials:MSW, LCSW
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 7061
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-0061
Mailing Address - Country:US
Mailing Address - Phone:252-908-4827
Mailing Address - Fax:
Practice Address - Street 1:112 N CIRCLE DR STE D
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-2429
Practice Address - Country:US
Practice Address - Phone:252-908-4827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0086441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical