Individual
MS. ALYSSA HAMILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW, LCAC-A
Contact information
Practice address
4109 W JEFFERSON BLVD, STE A, FORT WAYNE, IN 46804-6894
(260) 486-5251
(260) 486-5058
Mailing address
4109 W JEFFERSON BLVD, STE A, FORT WAYNE, IN 46804-6894
(260) 486-5251
(260) 486-5058
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
99118159A
IN
104100000X
Social Worker
Primary
33011020A
IN
Other
Enumeration date
06/02/2023
Last updated
05/13/2024
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