Provider Demographics
NPI:1487815437
Name:HAMILTON, SHANA VALERE (PHD)
Entity type:Individual
Prefix:DR
First Name:SHANA
Middle Name:VALERE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SHANA
Other - Middle Name:VALERE
Other - Last Name:HAMILTON-LOCKWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:204 BIRCHWOOD LANE
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862
Mailing Address - Country:US
Mailing Address - Phone:865-556-3474
Mailing Address - Fax:865-525-7494
Practice Address - Street 1:204 BIRCHWOOD LANE
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862
Practice Address - Country:US
Practice Address - Phone:865-556-3474
Practice Address - Fax:865-525-7494
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP2839103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling