Provider Demographics
NPI:1992371215
Name:HAMLIN, KATELYN JAE (LLMSW)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:JAE
Last Name:HAMLIN
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:JAE
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18 COLFAX ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MI
Mailing Address - Zip Code:49082-1139
Mailing Address - Country:US
Mailing Address - Phone:517-279-5275
Mailing Address - Fax:
Practice Address - Street 1:18 COLFAX ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MI
Practice Address - Zip Code:49082-1139
Practice Address - Country:US
Practice Address - Phone:517-279-5275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011064061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical