Provider Demographics
NPI:1245570969
Name:HAMPTON, ANTHONY (LMSW)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:HAMPTON
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 WHETSTONE CREEK CT
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-7848
Mailing Address - Country:US
Mailing Address - Phone:803-466-4496
Mailing Address - Fax:803-563-5345
Practice Address - Street 1:9 WHETSTONE CREEK CT
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-7848
Practice Address - Country:US
Practice Address - Phone:803-466-4496
Practice Address - Fax:803-563-5345
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10251103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSCOtherBLUE CROSS BLUE SHIELD
SCSCOtherCIGNA
SCSCOtherAETNA
SCSCOtherFEP