Provider Demographics
NPI:1437734050
Name:HAMPTON, RODERICK AGEE II (LPC, NCC)
Entity Type:Individual
Prefix:MR
First Name:RODERICK
Middle Name:AGEE
Last Name:HAMPTON
Suffix:II
Gender:M
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11000 WOOFERTON CT
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-1664
Mailing Address - Country:US
Mailing Address - Phone:804-803-4075
Mailing Address - Fax:
Practice Address - Street 1:11000 WOOFERTON CT
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-1664
Practice Address - Country:US
Practice Address - Phone:804-464-8996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704013319101YP2500X
VA0701011610101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA30017463120001Medicaid