Provider Demographics
NPI:1700277712
Name:HASTINGS, HAZEL DENISE (MS)
Entity Type:Individual
Prefix:MS
First Name:HAZEL
Middle Name:DENISE
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 S. DILLAR STRET
Mailing Address - Street 2:SUITE #340
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-3522
Mailing Address - Country:US
Mailing Address - Phone:407-656-6938
Mailing Address - Fax:407-656-9161
Practice Address - Street 1:213 S. DILLAR STRET
Practice Address - Street 2:SUITE #340
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3522
Practice Address - Country:US
Practice Address - Phone:407-656-6938
Practice Address - Fax:407-656-9161
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X
FL5694101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLUNKNOWNOtherADD TO GROUP