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General NPI Number Information
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NPI Number | 1972931343
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Entity Type | Individual
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Provider Name | JAMES HAMPTON LADC
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Gender | Male
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Dates
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Enumeration Date | 10/23/2013
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Last Update Date | 10/23/2013
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Provider Practice Location Address
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Address Line | 1900 SILVER LAKE RD., SUITE 110
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City | NEW BRIGHTON
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State | MN
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Zip | 55112
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Country | US
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Telephone | 651-628-9566
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Fax | 651-628-0411
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Provider Business Mailing Address
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Address Line | 4772 LINDAHL RD
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City | DULUTH
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State | MN
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Zip | 55811-1242
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Country | US
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Telephone | 218-348-6837
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 300349
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License Number State | MN
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