Provider Demographics
NPI:1821348160
Name:HAMILTON, PAMELA JEAN (LSCSW)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JEAN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9218 METCALF AVE STE 317
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-1476
Mailing Address - Country:US
Mailing Address - Phone:913-449-9300
Mailing Address - Fax:
Practice Address - Street 1:7930 SANTE FE DRIVE
Practice Address - Street 2:SUITE 108
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204
Practice Address - Country:US
Practice Address - Phone:913-449-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34007073A1041C0700X
MO20150115911041C0700X
KS48601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical