Provider Demographics
NPI:1952687261
Name:HATCH, ANGELA DAWN (LPC #16252)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:DAWN
Last Name:HATCH
Suffix:
Gender:F
Credentials:LPC #16252
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:DAWN
Other - Last Name:WHITMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1745 S ALMA SCHOOL RD STE 230
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3013
Mailing Address - Country:US
Mailing Address - Phone:480-668-8301
Mailing Address - Fax:480-558-3020
Practice Address - Street 1:1745 S ALMA SCHOOL RD SUITE 230
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210
Practice Address - Country:US
Practice Address - Phone:480-668-8301
Practice Address - Fax:480-558-3020
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16252101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional