Provider Demographics
NPI:1932418084
Name:HAMILTON, LINDA (LICSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LICSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 WHEELWRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-2238
Mailing Address - Country:US
Mailing Address - Phone:617-913-5064
Mailing Address - Fax:
Practice Address - Street 1:9 WHEELWRIGHT RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-2238
Practice Address - Country:US
Practice Address - Phone:781-396-3707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA339461103TS0200X
MA10285771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical