Provider Demographics
NPI:1013992551
Name:HATFIELD, ANGELA (LPC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:HATFIELD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:DR
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:KLINGENSMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1221 LANGSTON DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-3929
Mailing Address - Country:US
Mailing Address - Phone:614-570-2529
Mailing Address - Fax:614-451-0312
Practice Address - Street 1:547 SPINNING RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45431-2157
Practice Address - Country:US
Practice Address - Phone:937-252-1463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-07
Last Update Date:2022-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1901788101YM0800X
OH210411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH311712248OtherTIN