Provider Demographics
NPI:1609275528
Name:HYATT, KATHERINE SARGENT (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:SARGENT
Last Name:HYATT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:ELIZABETH
Other - Last Name:SARGENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:113 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:N SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-2370
Mailing Address - Country:US
Mailing Address - Phone:315-415-0308
Mailing Address - Fax:315-883-0711
Practice Address - Street 1:113 CHURCH ST
Practice Address - Street 2:
Practice Address - City:N SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-2370
Practice Address - Country:US
Practice Address - Phone:315-415-0308
Practice Address - Fax:315-883-0711
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-15
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005499101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health