Provider Demographics
NPI:1235313743
Name:HOLLY HATCH LCSW PC
Entity Type:Organization
Organization Name:HOLLY HATCH LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HATCH
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:406-932-6025
Mailing Address - Street 1:1116 HIGHWAY 191
Mailing Address - Street 2:
Mailing Address - City:BIG TIMBER
Mailing Address - State:MT
Mailing Address - Zip Code:59011-7708
Mailing Address - Country:US
Mailing Address - Phone:406-932-6025
Mailing Address - Fax:406-932-6025
Practice Address - Street 1:418 FIRST ST
Practice Address - Street 2:
Practice Address - City:BIG TIMBER
Practice Address - State:MT
Practice Address - Zip Code:59011
Practice Address - Country:US
Practice Address - Phone:406-932-6025
Practice Address - Fax:406-932-6025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT536101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty