Provider Demographics
NPI:1932958816
Name:HAMLIN, SUSAN HELAINE (LCSW)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:HELAINE
Last Name:HAMLIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2059
Mailing Address - Street 2:
Mailing Address - City:GUALALA
Mailing Address - State:CA
Mailing Address - Zip Code:95445-2059
Mailing Address - Country:US
Mailing Address - Phone:650-281-9885
Mailing Address - Fax:
Practice Address - Street 1:222 SEA DRIFT
Practice Address - Street 2:
Practice Address - City:THE SEA RANCH
Practice Address - State:CA
Practice Address - Zip Code:95497
Practice Address - Country:US
Practice Address - Phone:650-281-9885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA132481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical