Provider Demographics
NPI:1801924691
Name:HAMPTON, DOROTHY W (CMSW)
Entity type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:W
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:CMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 843
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37334-0843
Mailing Address - Country:US
Mailing Address - Phone:931-433-7133
Mailing Address - Fax:
Practice Address - Street 1:607B S POLK ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-3968
Practice Address - Country:US
Practice Address - Phone:931-461-1360
Practice Address - Fax:941-461-1372
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNCSW00000068181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical