Provider Demographics
NPI:1356432801
Name:HAMPTON MENTAL HEALTH ASSOCIATES, INC
Entity type:Organization
Organization Name:HAMPTON MENTAL HEALTH ASSOCIATES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:RUPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-826-7516
Mailing Address - Street 1:2112 HARTFORD RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2409
Mailing Address - Country:US
Mailing Address - Phone:757-826-7516
Mailing Address - Fax:757-224-3387
Practice Address - Street 1:2112 HARTFORD RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2409
Practice Address - Country:US
Practice Address - Phone:757-826-7516
Practice Address - Fax:757-826-6232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA276101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004943805Medicaid