Provider Demographics
NPI:1962237248
Name:HATCH, NIC
Entity type:Individual
Prefix:
First Name:NIC
Middle Name:
Last Name:HATCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1347 MONTROSE AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-5859
Mailing Address - Country:US
Mailing Address - Phone:681-209-1237
Mailing Address - Fax:
Practice Address - Street 1:301 SCOTT AVE
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-8804
Practice Address - Country:US
Practice Address - Phone:304-296-1731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker