Provider Demographics
NPI:1902678766
Name:HAMILTON, REBECCA EILEEN (LCSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:EILEEN
Last Name:HAMILTON
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 1:38 E WASHINGTON ST STE 6
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3974
Mailing Address - Country:US
Mailing Address - Phone:406-260-2394
Mailing Address - Fax:
Practice Address - Street 1:38 E WASHINGTON ST STE 6
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3974
Practice Address - Country:US
Practice Address - Phone:406-260-2394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-25
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-SWLC-LIC-498331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical