Provider Demographics
NPI:1023796877
Name:HAMILTON, CHEL'LE LACHON I
Entity type:Individual
Prefix:MR
First Name:CHEL'LE
Middle Name:LACHON
Last Name:HAMILTON
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6005 ROSEBUD LN APT 105
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-5184
Mailing Address - Country:US
Mailing Address - Phone:310-767-6713
Mailing Address - Fax:
Practice Address - Street 1:8133 LEESBURG PIKE STE 130
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2706
Practice Address - Country:US
Practice Address - Phone:703-682-0163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0906014169104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker