Doctor Name: | MRS. ADDIE HAMPTON |
NPI Number: | 1366643439 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CASAC LMHC CRC LPN |
License Number: | 12290 |
Business Practice Address: | 27 Champlin Avenue Bellport, NY - 11713 |
Business Phone Number: | 6316615518 |
Business Fax Number: | |
Mailing Address: | 440 Spangle Drive, NORTH BABYLON |
State: | NY |
Postal Code: | 11703 |
Phone Number: | 6313218655 |
Fax Number: | |
NPI Enumeration Date: | 05/29/2007 |
NPI Last Update Date: | 01/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 12290 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |