Provider Demographics
NPI:1184409427
Name:HAMILTON, JOHN ARTHUR
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ARTHUR
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 LOCUST AVE STE 2A
Mailing Address - Street 2:
Mailing Address - City:NEW CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06840-4735
Mailing Address - Country:US
Mailing Address - Phone:203-858-8028
Mailing Address - Fax:
Practice Address - Street 1:21 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:NEW CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06840-4735
Practice Address - Country:US
Practice Address - Phone:203-858-8028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000596106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty