Provider Demographics
NPI:1760598635
Name:HAMILTON, HAYLEY ANN (LICSW)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:ANN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 BEECH TREE LN
Mailing Address - Street 2:
Mailing Address - City:WAITSFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05673-7029
Mailing Address - Country:US
Mailing Address - Phone:802-224-6096
Mailing Address - Fax:802-496-7095
Practice Address - Street 1:65 NORTHGATE PLAZA
Practice Address - Street 2:SUITE 11
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661-5900
Practice Address - Country:US
Practice Address - Phone:802-888-8320
Practice Address - Fax:802-888-8136
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089-00012731041C0700X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No251S00000XAgenciesCommunity/Behavioral Health