1043618994 NPI number — MRS. TAMARA HOUSTON-HAMILTON LMSW, LISW-CP

Table of content: MRS. TAMARA HOUSTON-HAMILTON LMSW, LISW-CP (NPI 1043618994)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043618994 NPI number — MRS. TAMARA HOUSTON-HAMILTON LMSW, LISW-CP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOUSTON-HAMILTON
Provider First Name:
TAMARA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMSW, LISW-CP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOUSTON
Provider Other First Name:
TAMARA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMSW, LISW-CP
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1043618994
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/06/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3042
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EASLEY
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29641-3042
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-416-4560
Provider Business Mailing Address Fax Number:
866-204-1733

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1097 S PENDLETON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EASLEY
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29642-1050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-416-4560
Provider Business Practice Location Address Fax Number:
864-236-7311
Provider Enumeration Date:
12/09/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  8450 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 30258068 . This is a "SELECT HEALTH" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: Q51117G199 . This is a "MEDICARE PTAN" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 1043618994 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 8450 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 829755 . This is a "BEACON HEALTH OPTIONS" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".




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