Healthcare Provider Details

I. General information

NPI: 1992005425
Provider Name (Legal Business Name): PRUDENCE LAQUITA HATCHETT MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2010
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5137 FAIN LN
BELDEN MS
38826-9751
US

IV. Provider business mailing address

5137 FAIN LN
BELDEN MS
38826-9751
US

V. Phone/Fax

Practice location:
  • Phone: 662-871-4569
  • Fax:
Mailing address:
  • Phone: 662-871-4569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2223
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: