Provider Demographics
NPI:1205977097
Name:HOTCHKISS, MABEL SCOTTIE (LCSW)
Entity type:Individual
Prefix:
First Name:MABEL
Middle Name:SCOTTIE
Last Name:HOTCHKISS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 W 16TH ST
Mailing Address - Street 2:STE C
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364
Mailing Address - Country:US
Mailing Address - Phone:928-343-1670
Mailing Address - Fax:928-343-9296
Practice Address - Street 1:1405 W 16TH ST
Practice Address - Street 2:STE C
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364
Practice Address - Country:US
Practice Address - Phone:928-343-1670
Practice Address - Fax:928-343-9296
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW06371041C0700X
AZLMFT0116106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZCSW637IMedicare ID - Type Unspecified