Provider Demographics
NPI:1720149404
Name:HAMILTON, CHRISTOPHER (LMHC, PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:LMHC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 HACKETT BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3499
Mailing Address - Country:US
Mailing Address - Phone:518-262-5511
Mailing Address - Fax:518-262-6111
Practice Address - Street 1:25 HACKETT BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3499
Practice Address - Country:US
Practice Address - Phone:518-262-5511
Practice Address - Fax:518-262-6111
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6104101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1303546Medicaid
MA1303546Medicaid
MAY10138Medicare ID - Type UnspecifiedMEDICARE PART B