Provider Demographics
NPI:1508379561
Name:HAMPTON, MICHELLE D (MS, LPC)
Entity Type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:D
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8405 TITKOS DR APT 203
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34747-3308
Mailing Address - Country:US
Mailing Address - Phone:414-737-8060
Mailing Address - Fax:
Practice Address - Street 1:5850 T G LEE BLVD STE 400
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-4409
Practice Address - Country:US
Practice Address - Phone:800-338-3738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-13
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3749226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty