Provider Demographics
NPI:1356765713
Name:SMITH-HAMILTON, PHINA (LMSW)
Entity type:Individual
Prefix:MS
First Name:PHINA
Middle Name:
Last Name:SMITH-HAMILTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23461 HAGGERTY RD
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-3727
Mailing Address - Country:US
Mailing Address - Phone:313-304-2353
Mailing Address - Fax:
Practice Address - Street 1:20100 MIDWAY AVE
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-7533
Practice Address - Country:US
Practice Address - Phone:313-304-2353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010782861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical