Provider Demographics
NPI:1558507236
Name:HATFIELD, VICTORIA LYNN (LMFT, LSW)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:LYNN
Last Name:HATFIELD
Suffix:
Gender:F
Credentials:LMFT, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2203 CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-1705
Mailing Address - Country:US
Mailing Address - Phone:502-724-4355
Mailing Address - Fax:502-384-4011
Practice Address - Street 1:2203 CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-1705
Practice Address - Country:US
Practice Address - Phone:502-724-4355
Practice Address - Fax:502-384-4011
Is Sole Proprietor?:No
Enumeration Date:2008-12-30
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33001636A104100000X
KYKY-0025106H00000X
IN35000772A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY11545115OtherCAQH ID NUMBER