Provider Demographics
NPI:1790881928
Name:HAMILTON, DANIEL W (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:W
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 GUINEA RD
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04046-5136
Mailing Address - Country:US
Mailing Address - Phone:207-423-7140
Mailing Address - Fax:
Practice Address - Street 1:9 OLD SAWMILL LN
Practice Address - Street 2:
Practice Address - City:ARUNDEL
Practice Address - State:ME
Practice Address - Zip Code:04046-8164
Practice Address - Country:US
Practice Address - Phone:207-423-7140
Practice Address - Fax:207-294-4649
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS1049103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME198160099Medicaid