Healthcare Provider Details

I. General information

NPI: 1720368004
Provider Name (Legal Business Name): NATALIE HASSELL MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NATALIE KOOI MA

II. Dates (important events)

Enumeration Date: 08/18/2011
Last Update Date: 08/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 E 3RD ST
FLINT MI
48502-1728
US

IV. Provider business mailing address

129 E 3RD ST
FLINT MI
48502-1728
US

V. Phone/Fax

Practice location:
  • Phone: 810-233-4031
  • Fax:
Mailing address:
  • Phone: 810-233-4031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401009564
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: