Provider Demographics
NPI:1699255265
Name:HAMPTON, JESSICA L (LCSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 NEWCASTLE CIR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:CO
Mailing Address - Zip Code:80816-9210
Mailing Address - Country:US
Mailing Address - Phone:217-264-6018
Mailing Address - Fax:
Practice Address - Street 1:6071 E WOODMEN RD STE 405
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-2614
Practice Address - Country:US
Practice Address - Phone:719-571-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
COCSW.09925455104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical