Healthcare Provider Details

I. General information

NPI: 1013480417
Provider Name (Legal Business Name): DJUANA HAMPTON-RICE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2019
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29350 MARIMOOR DR
SOUTHFIELD MI
48076-1615
US

IV. Provider business mailing address

29350 MARIMOOR DR
SOUTHFIELD MI
48076-1615
US

V. Phone/Fax

Practice location:
  • Phone: 248-525-0883
  • Fax: 866-731-3823
Mailing address:
  • Phone: 248-525-0883
  • Fax: 866-731-3823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.027822
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: