Provider Demographics
NPI:1629518436
Name:COMPTON, VIRGINIA
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:COMPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E MAIN ST STE 207
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-2485
Mailing Address - Country:US
Mailing Address - Phone:919-879-8048
Mailing Address - Fax:919-516-0698
Practice Address - Street 1:333 E MAIN ST STE 207
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-2485
Practice Address - Country:US
Practice Address - Phone:919-879-8048
Practice Address - Fax:919-516-0698
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-27
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10688101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health