Provider Demographics
NPI:1730427162
Name:HAMPTON, LAURISSA LYNN MALLOZZI
Entity type:Individual
Prefix:
First Name:LAURISSA
Middle Name:LYNN MALLOZZI
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAURISSA
Other - Middle Name:LYNN
Other - Last Name:MALLOZZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC CASAC
Mailing Address - Street 1:1545 ATLANTIC AVE
Mailing Address - Street 2:3RD FL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-1122
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1545 ATLANTIC AVE
Practice Address - Street 2:3RD FL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-1122
Practice Address - Country:US
Practice Address - Phone:718-613-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health