Provider Demographics
NPI:1053787267
Name:HAMILTON, BRIAN J (LMFT, MS)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:J
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:LMFT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 MAIN ST STE 6C
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-3109
Mailing Address - Country:US
Mailing Address - Phone:603-836-5003
Mailing Address - Fax:603-836-5004
Practice Address - Street 1:151 MAIN ST STE 6C
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-3109
Practice Address - Country:US
Practice Address - Phone:603-836-5003
Practice Address - Fax:603-836-5004
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH235106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist