Provider Demographics
NPI:1700661592
Name:HAMPTON, LAQUITA DANIELLE (LMSW)
Entity Type:Individual
Prefix:
First Name:LAQUITA
Middle Name:DANIELLE
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4798 PENCARROW CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-2372
Mailing Address - Country:US
Mailing Address - Phone:177-344-1027
Mailing Address - Fax:
Practice Address - Street 1:5851 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1290
Practice Address - Country:US
Practice Address - Phone:702-732-0304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10676-M1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical