Mark Theodore Hamilton, LLP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6361004091 Issued in MI

Practice address

450 Meadow Run Dr
Hastings, MI 49058-9053

Phone

(616) 891-8770

Fax

(616) 891-3504

NPI assigned

Jun 30, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1003845314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 MEADOW RUN DR",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490589053",
            "telephone_number": "616-891-8770",
            "fax_number": "616-891-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "MARK",
        "middle_name": "THEODORE",
        "credential": "LLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301009792",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361004091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "P10D11275",
            "identifier": "BC/BS",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Elizabeth Haasch, OT
• Megan Haber, DO
• Tyron Hacker, LMSW
• Glenn Emil Hahn, DDS
• Ashly Hamberg, LLP
• Karen Hammond, PTA
• Hanover Home Care, Inc.
• Amy Ossiff Hansen
• David D Harrell, M.D.
• Joleigha Harrington, LMSW

• Psychologist in Hastings, MI
• Providers in Hastings, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.