Provider Demographics
NPI:1336802461
Name:HUTCHINSON MENTAL HEALTH, LLC
Entity Type:Organization
Organization Name:HUTCHINSON MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN ASSIST
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BURDETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-200-2209
Mailing Address - Street 1:1206 N MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67501-4501
Mailing Address - Country:US
Mailing Address - Phone:620-860-5002
Mailing Address - Fax:620-860-5002
Practice Address - Street 1:1206 N MAIN STREET
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501-4501
Practice Address - Country:US
Practice Address - Phone:620-860-5002
Practice Address - Fax:620-860-5002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUTCHINSON MENTAL HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSKA4802OtherPTAN