Provider Demographics
NPI:1144735176
Name:HAMILTON, CINDY (LCSW)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
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:PO BOX 20996
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003-7020
Mailing Address - Country:US
Mailing Address - Phone:307-256-8486
Mailing Address - Fax:
Practice Address - Street 1:2105 CENTRAL AVENUE
Practice Address - Street 2:SUITE 3
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-7020
Practice Address - Country:US
Practice Address - Phone:307-256-8486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-13
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY759104100000X
WY13051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker