Provider Demographics
NPI:1700031366
Name:HATCH, SHERRY LYNNE (LLP)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:LYNNE
Last Name:HATCH
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:LYNNE
Other - Last Name:HATCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLP
Mailing Address - Street 1:11352 E SHORE DR
Mailing Address - Street 2:
Mailing Address - City:WHITMORE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48189-9326
Mailing Address - Country:US
Mailing Address - Phone:734-449-4253
Mailing Address - Fax:
Practice Address - Street 1:11352 E SHORE DR
Practice Address - Street 2:
Practice Address - City:WHITMORE LAKE
Practice Address - State:MI
Practice Address - Zip Code:48189-9326
Practice Address - Country:US
Practice Address - Phone:734-449-4253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006421103K00000X, 103TB0200X, 103TF0000X, 103TM1800X
6301006421103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities