Provider Demographics
NPI:1386479228
Name:HAMPTON, BENJAMIN (APC)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:HAMPTON
Suffix:
Gender:M
Credentials:APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 LEXINGTON FARMS DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-6744
Mailing Address - Country:US
Mailing Address - Phone:229-220-1703
Mailing Address - Fax:
Practice Address - Street 1:515 E CROSSVILLE RD STE 140
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-5861
Practice Address - Country:US
Practice Address - Phone:229-220-1703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC009894101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional