Healthcare Provider Details

I. General information

NPI: 1659688422
Provider Name (Legal Business Name): OYA WESTON HAMPTON PH. D., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OYA WESTON STATEN PH. D., LPC

II. Dates (important events)

Enumeration Date: 09/01/2010
Last Update Date: 08/17/2020
Certification Date: 08/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9056B COLLINSVILLE RD
COLLINSVILLE MS
39325-9100
US

IV. Provider business mailing address

4820A POPLAR SPG DR # 112
MERIDIAN MS
39305-2624
US

V. Phone/Fax

Practice location:
  • Phone: 601-462-7906
  • Fax: 601-581-7676
Mailing address:
  • Phone: 601-462-7902
  • Fax: 601-581-7676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0911
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: