Provider Demographics
NPI:1407677248
Name:HATCH, KYLE (MFTC)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:HATCH
Suffix:
Gender:M
Credentials:MFTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 MILESTONE DR STE 103
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5761
Mailing Address - Country:US
Mailing Address - Phone:970-829-8780
Mailing Address - Fax:
Practice Address - Street 1:2120 MILESTONE DR STE 103
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5761
Practice Address - Country:US
Practice Address - Phone:970-829-8780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14362106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist