Provider Demographics
NPI:1730727900
Name:HAMPTON, TIFFANY (LCSW-C)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 PATAPSCO AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3118
Mailing Address - Country:US
Mailing Address - Phone:443-418-0447
Mailing Address - Fax:
Practice Address - Street 1:524 PATAPSCO AVE
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-3118
Practice Address - Country:US
Practice Address - Phone:443-418-0447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-18
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD231821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical