Provider Demographics
NPI:1952376246
Name:HAMPTON, KARIN LOU (PHD LP)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:LOU
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:PHD LP
Other - Prefix:
Other - First Name:KARIN
Other - Middle Name:L
Other - Last Name:HAMPTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3333 UNIVERSITY AVE SE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-3325
Mailing Address - Country:US
Mailing Address - Phone:612-331-9413
Mailing Address - Fax:612-728-5301
Practice Address - Street 1:3333 UNIVERSITY AVE SE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-3325
Practice Address - Country:US
Practice Address - Phone:612-331-9413
Practice Address - Fax:612-728-5301
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2118103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN196252300Medicaid
MN196252300Medicaid
R64452Medicare UPIN