Provider Demographics
NPI:1023757986
Name:HAMLET, AMANDA DAWN (LCSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:DAWN
Last Name:HAMLET
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:DAWN
Other - Last Name:BROTHERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5824 HIGHWAY 405
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-9580
Mailing Address - Country:US
Mailing Address - Phone:270-315-6514
Mailing Address - Fax:
Practice Address - Street 1:111 W 3RD ST STE 5
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-4120
Practice Address - Country:US
Practice Address - Phone:270-315-6514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2596871041C0700X
KY2569431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical