Provider Demographics
NPI:1295956274
Name:HAMLIN, KATHLEEN K (LCSW)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:K
Last Name:HAMLIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6414
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-6414
Mailing Address - Country:US
Mailing Address - Phone:317-727-9992
Mailing Address - Fax:317-872-1756
Practice Address - Street 1:3333 FOUNDERS ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1366
Practice Address - Country:US
Practice Address - Phone:317-872-1749
Practice Address - Fax:317-872-1756
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004653A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical