Provider Demographics
NPI:1407826852
Name:HATCH, RICHARD J (LCSW)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:J
Last Name:HATCH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 FLEMING DR
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2904
Mailing Address - Country:US
Mailing Address - Phone:801-971-4183
Mailing Address - Fax:
Practice Address - Street 1:770 FLEMING DR
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2904
Practice Address - Country:US
Practice Address - Phone:801-971-4183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT137410-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT261902OtherDESERET MUTUAL BENEFIT
UTU000074809Medicare PIN
UT261902OtherDESERET MUTUAL BENEFIT