Provider Demographics
NPI:1912666975
Name:HAMILTON, KAITLYN (LMHC)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 NORMANDALE DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-1619
Mailing Address - Country:US
Mailing Address - Phone:585-590-6289
Mailing Address - Fax:
Practice Address - Street 1:56 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4433
Practice Address - Country:US
Practice Address - Phone:585-524-0008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011622101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health