=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740717420
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NICHOLAS EDWARD HAMPTON
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/12/2017
-----------------------------------------------------
Last Update Date | 01/21/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 129 N LOCUST AVE
-----------------------------------------------------
City | LAWRENCEBURG
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38464-3757
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-253-1110
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 507 3RD AVE W
-----------------------------------------------------
City | SPRINGFIELD
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37172-2017
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-727-4067
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 5740
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------