Provider Demographics
NPI:1154787943
Name:HAMLIN, THERESA (MDIV, LPC, CACII)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:HAMLIN
Suffix:
Gender:F
Credentials:MDIV, LPC, CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:756 WOODBURY HWY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30222-1514
Mailing Address - Country:US
Mailing Address - Phone:706-672-1118
Mailing Address - Fax:
Practice Address - Street 1:756 WOODBURY HWY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:GA
Practice Address - Zip Code:30222-1514
Practice Address - Country:US
Practice Address - Phone:706-672-1118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-08
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1978101YA0400X
GALPC010751101YM0800X
GA101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral