Healthcare Provider Details

I. General information

NPI: 1336802461
Provider Name (Legal Business Name): HUTCHINSON MENTAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2021
Last Update Date: 10/15/2021
Certification Date: 10/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1206 N MAIN STREET
HUTCHINSON KS
67501-4501
US

IV. Provider business mailing address

1206 N MAIN STREET
HUTCHINSON KS
67501-4501
US

V. Phone/Fax

Practice location:
  • Phone: 620-860-5002
  • Fax: 620-860-5002
Mailing address:
  • Phone: 620-860-5002
  • Fax: 620-860-5002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH ELIZABETH BURDETTE
Title or Position: ADMIN ASSIST
Credential:
Phone: 620-200-2209