Provider Demographics
NPI:1245734839
Name:HAMILTON, NATASHA NICOLE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:NICOLE
Last Name:HAMILTON
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:NICOLE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:303 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OK
Mailing Address - Zip Code:74020-3421
Mailing Address - Country:US
Mailing Address - Phone:539-209-1209
Mailing Address - Fax:539-203-3672
Practice Address - Street 1:303 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OK
Practice Address - Zip Code:74020-3421
Practice Address - Country:US
Practice Address - Phone:539-209-1209
Practice Address - Fax:539-203-3672
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7517104100000X
OKBACB1280718106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician