Provider Demographics
NPI:1295968725
Name:HAMILTON, CHRISTINE (LCSW; PHD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LCSW; PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 WEST END AVE
Mailing Address - Street 2:1 B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023
Mailing Address - Country:US
Mailing Address - Phone:212-932-1710
Mailing Address - Fax:
Practice Address - Street 1:255 WEST END AVE
Practice Address - Street 2:1 B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023
Practice Address - Country:US
Practice Address - Phone:212-932-1710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR023263-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNK601OtherMEDICARE