Provider Demographics
NPI:1679018055
Name:HAMPTON, JAIME (MA)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:MA
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 441
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44005-0441
Mailing Address - Country:US
Mailing Address - Phone:440-381-8107
Mailing Address - Fax:
Practice Address - Street 1:1820 S RIDGE RD W
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-9039
Practice Address - Country:US
Practice Address - Phone:440-381-8107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1500537101YP2500X
OHE.1901058101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional