Individual
MR. HENRY DUANE HAMILTON I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCADC, ICADC, CAMF
Contact information
Practice address
60 EVERGREEN PL STE 200&904, EAST ORANGE, NJ 07018
(973) 678-6015
(973) 678-3968
Mailing address
60 EVERGREEN PL STE 200&904, EAST ORANGE, NJ 07018-2106
(973) 678-3966
(973) 678-3968
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
37LC00118000
NJ
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00118000
NJ
101YM0800X
Mental Health Counselor
37AC00086900
NJ
101YP1600X
Pastoral Counselor
37CL00118000
NJ
1041C0700X
Clinical Social Worker
44SC05363800
NJ
207RA0401X
Addiction Medicine (Internal Medicine) Physician
37LC00118000
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
NO106752
NJ
390200000X
Student in an Organized Health Care Education/Training Program
37LC00118000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0490717
—
NJ
05
—
0491187
—
NJ
01
—
11890384
CAQH
NJ
01
—
8576195
AETNA
NJ
Enumeration date
04/17/2009
Last updated
09/06/2018
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