Provider Demographics
NPI:1952512592
Name:HAMPTON, ELIZABETH ALBERTA (MSSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ALBERTA
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-6203
Mailing Address - Country:US
Mailing Address - Phone:407-317-7430
Mailing Address - Fax:407-540-1924
Practice Address - Street 1:601 W MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-6203
Practice Address - Country:US
Practice Address - Phone:407-317-7430
Practice Address - Fax:407-540-1924
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
FLSW136291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104247100Medicaid