Basic Information
| Provider Information | |||||||||
| NPI: | 1760598635 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAMILTON | ||||||||
| FirstName: | HAYLEY | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | LICSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 93 BEECH TREE LN | ||||||||
| Address2: | |||||||||
| City: | WAITSFIELD | ||||||||
| State: | VT | ||||||||
| PostalCode: | 056737029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8022246096 | ||||||||
| FaxNumber: | 8024967095 | ||||||||
| Practice Location | |||||||||
| Address1: | 65 NORTHGATE PLAZA | ||||||||
| Address2: | SUITE 11 | ||||||||
| City: | MORRISVILLE | ||||||||
| State: | VT | ||||||||
| PostalCode: | 056615900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8028888320 | ||||||||
| FaxNumber: | 8028888136 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2006 | ||||||||
| LastUpdateDate: | 06/04/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 089-0001273 | VT | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 251S00000X | 089-0001273 | VT | N | Agencies | Community/Behavioral Health |
No ID Information.