Healthcare Provider Details

I. General information

NPI: 1003218850
Provider Name (Legal Business Name): CHELSEA HAMPTON MSW PCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2014
Last Update Date: 09/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 E 25TH ST
CHEYENNE WY
82001-3133
US

IV. Provider business mailing address

604 E 25TH ST
CHEYENNE WY
82001-3133
US

V. Phone/Fax

Practice location:
  • Phone: 307-637-3953
  • Fax:
Mailing address:
  • Phone: 307-637-3953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: