Provider Demographics
NPI:1922115542
Name:HAMILTON, BEATRICE (EDD)
Entity Type:Individual
Prefix:
First Name:BEATRICE
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 EAST STATE STREET
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:MD
Mailing Address - Zip Code:21875
Mailing Address - Country:US
Mailing Address - Phone:410-896-2149
Mailing Address - Fax:410-896-2825
Practice Address - Street 1:28 EAST STATE STREET
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:MD
Practice Address - Zip Code:21875
Practice Address - Country:US
Practice Address - Phone:410-896-2149
Practice Address - Fax:410-896-2825
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10644101YA0400X
MDLCM061106H00000X
MDLC0337101YM0800X
DE0000023101YM0800X
DECD-0000023101YA0400X
DEFT-0000006106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD945701100Medicaid