Provider Demographics
NPI:1295024396
Name:HAMPTON, KATHERINE LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LEE
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:LEE
Other - Last Name:LAROCCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW, LCSW
Mailing Address - Street 1:188 DALEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WILLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06279-2104
Mailing Address - Country:US
Mailing Address - Phone:860-875-2578
Mailing Address - Fax:860-875-9963
Practice Address - Street 1:384 MERROW RD
Practice Address - Street 2:SUITE P
Practice Address - City:TOLLAND
Practice Address - State:CT
Practice Address - Zip Code:06084-3957
Practice Address - Country:US
Practice Address - Phone:860-875-2578
Practice Address - Fax:860-875-9963
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0053521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical