Provider Demographics
NPI:1831521798
Name:HATFIELD, MARK A (LPCC, NCC, CCMHC)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:A
Last Name:HATFIELD
Suffix:
Gender:M
Credentials:LPCC, NCC, CCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 2ND ST STE 201
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-4094
Mailing Address - Country:US
Mailing Address - Phone:859-414-6088
Mailing Address - Fax:606-727-9566
Practice Address - Street 1:237 2ND ST STE 201
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-4094
Practice Address - Country:US
Practice Address - Phone:859-414-6088
Practice Address - Fax:606-727-9566
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-02
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000005569101YM0800X
WALH-61163612101YM0800X
IL180008178101YM0800X
MI6401016742101YP2500X
KY252582101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100732450Medicaid
TNLPC0000005569OtherLPC-MHSP
WALH-61163612OtherLMHC
12593397OtherCAQH
KY252582OtherLPCC
IL180008178OtherLCPC
MI6401016742OtherLPC