Provider Demographics
NPI:1861938870
Name:HAMILTON, NIKKI RENEE (MS)
Entity type:Individual
Prefix:
First Name:NIKKI
Middle Name:RENEE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MS
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 4947
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59702-4947
Mailing Address - Country:US
Mailing Address - Phone:360-888-4577
Mailing Address - Fax:
Practice Address - Street 1:324 S EXCELSIOR AVE
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1537
Practice Address - Country:US
Practice Address - Phone:360-888-4577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-13
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-55109101YM0800X
WA60562020101Y00000X
MC101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health