Provider Demographics
NPI:1700767472
Name:HAMILTON, ALESA ROCHELLE
Entity type:Individual
Prefix:
First Name:ALESA
Middle Name:ROCHELLE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 RAVEN TRL APT 12103
Mailing Address - Street 2:
Mailing Address - City:ALEDO
Mailing Address - State:TX
Mailing Address - Zip Code:76008-2197
Mailing Address - Country:US
Mailing Address - Phone:817-823-1316
Mailing Address - Fax:
Practice Address - Street 1:3600 RAVEN TRL APT 12103
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-2197
Practice Address - Country:US
Practice Address - Phone:817-823-1316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99601101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health