Hamilton, Jerry
Hamilton, Jerry is an individual health care provider with primary practice located at 7165 Getwell Rd , Southaven MS 38672-9618. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Hamilton, Jerry can be contacted via phone (662) 349-2818.Contact Information
Primary practice address
7165 Getwell Rd
Southaven MS 38672-9618
Phone: (662) 349-2818
Fax: (662) 342-3406
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 3165 | Tennessee |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1502 | Arkansas |
Profile Details
| NPI number | 1831386747 |
|---|---|
| LBN Legal business name | Hamilton, Jerry |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 25th, 2007 |
| Last updated | May 9th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831386747 | NPPES |
| Tennessee | MEDICAID | 3699016 | |
| Tennessee | Other | 568759-000 | |
| Tennessee | Other | 11549639 | |
| Tennessee | Other | 4114450 |
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