Jerry Hamilton, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3165 Issued in TN

Practice address

7165 Getwell Rd
Southaven, MS 38672-9618

Phone

(662) 349-2818

Fax

(662) 342-3406

NPI assigned

Sep 25, 2007

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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Psycamore LLC

  • Adult Mental Health Clinic/Center
  • Southaven, MS
  • NPI 1770886012
  NPD (past)
• Branches of Life, Inc.

  • Clinical Social Worker
  • Memphis, TN
  • NPI 1609959212
  NPD (past)

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336521600000",
    "number": "1831386747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7165 GETWELL DRIVE",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "381091722",
            "telephone_number": "901-345-0636",
            "fax_number": "662-772-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7165 GETWELL RD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386729618",
            "telephone_number": "662-349-2818",
            "fax_number": "662-342-3406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "JERRY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-25",
        "last_updated": "2012-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "3165",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "1502",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3699016",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN HEALTH CARE",
            "identifier": "568759-000",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH AETNA",
            "identifier": "11549639",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4114450",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Alice Hall, CRNA
• Olivia Hall
• Halo Express
• Hamad Ahmad MD PC
• Hamilton Chiropractic Center, PLLC
• Lolethia Hamilton, D C
• Nathan Reed Hamman, D.D.S., M.D.S.
• Leslie Jean Hammond, MS CCC-SLP
• Cierra Hampton
• Beth Hand, L.C.S.W.

• Clinical Social Worker in Southaven, MS
• Providers in Southaven, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2012; 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.