Provider Demographics
NPI:1679046007
Name:HATCH, RYAN ERIC (MSED, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:ERIC
Last Name:HATCH
Suffix:
Gender:M
Credentials:MSED, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 TEEL BROOKE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151-3999
Mailing Address - Country:US
Mailing Address - Phone:540-238-9551
Mailing Address - Fax:
Practice Address - Street 1:730 E CHURCH ST STE 24
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-3151
Practice Address - Country:US
Practice Address - Phone:276-226-2827
Practice Address - Fax:276-638-8006
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA071008063101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional