Individual
MS. JACQUELINE D HAMILTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
16208 PENTERRA WAY, BOWIE, MD 20716-1919
(301) 996-1677
Mailing address
16208 PENTERRA WAY, BOWIE, MD 20716-1919
(301) 996-1677
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
510345
MD
101YM0800X
Mental Health Counselor
Primary
LC4137
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
441512400
—
MD
Enumeration date
09/10/2018
Last updated
03/18/2024
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