Provider Demographics
NPI:1295574093
Name:VICKY E HAMPTON
Entity type:Organization
Organization Name:VICKY E HAMPTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:E
Authorized Official - Last Name:HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:LADC, LPC
Authorized Official - Phone:405-777-9459
Mailing Address - Street 1:1401 NW 150TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-2169
Mailing Address - Country:US
Mailing Address - Phone:405-777-9459
Mailing Address - Fax:
Practice Address - Street 1:1401 NW 150TH ST STE A
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-2169
Practice Address - Country:US
Practice Address - Phone:405-777-9459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty