Provider Demographics
NPI:1437825338
Name:MISTRETTA-HAMILTON, FAITHE RHIANNON (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:FAITHE
Middle Name:RHIANNON
Last Name:MISTRETTA-HAMILTON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7510 HOLLY HILL DR APT 143
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4522
Mailing Address - Country:US
Mailing Address - Phone:214-425-5735
Mailing Address - Fax:
Practice Address - Street 1:10300 N CENTRAL EXPY STE 220
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-8626
Practice Address - Country:US
Practice Address - Phone:972-884-5923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX615821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX61582OtherSOCIAL WORK LICENSE