Provider Demographics
NPI:1568658706
Name:HAMPTON, CATHERINE CASCILLE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:CASCILLE
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CASCILLE
Other - Middle Name:
Other - Last Name:ANDELA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:24302 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1150
Mailing Address - Country:US
Mailing Address - Phone:718-423-6200
Mailing Address - Fax:718-423-9762
Practice Address - Street 1:24302 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:DOUGLASTON
Practice Address - State:NY
Practice Address - Zip Code:11362-1150
Practice Address - Country:US
Practice Address - Phone:718-423-6200
Practice Address - Fax:718-423-9762
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074303-11041C0700X
NY079440-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical