Provider Demographics
NPI:1063602902
Name:HAMILTON, STEPHANIE R (LPCMH)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:R
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:A
Other - Last Name:RENSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCMH
Mailing Address - Street 1:405 FOULK RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3809
Mailing Address - Country:US
Mailing Address - Phone:302-893-5405
Mailing Address - Fax:
Practice Address - Street 1:405 FOULK RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3809
Practice Address - Country:US
Practice Address - Phone:302-893-5405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000416101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health