Provider Demographics
NPI:1447136221
Name:HAMILTON, CAMERON TYE (LCSW)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:TYE
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 PIGEON ROOST RD
Mailing Address - Street 2:
Mailing Address - City:RUSH
Mailing Address - State:KY
Mailing Address - Zip Code:41168-8132
Mailing Address - Country:US
Mailing Address - Phone:606-928-6648
Mailing Address - Fax:606-928-1056
Practice Address - Street 1:211 S CAROL MALONE BLVD
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:KY
Practice Address - Zip Code:41143-1355
Practice Address - Country:US
Practice Address - Phone:606-713-0379
Practice Address - Fax:606-547-4329
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYLCSW000010771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical