Healthcare Provider Details

I. General information

NPI: 1174249403
Provider Name (Legal Business Name): HOTCH HEALING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2022
Last Update Date: 10/18/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 BUSINESS PARK EAST
WAKE FOREST NC
27587
US

IV. Provider business mailing address

1133 BUTTERCUP LN
WAKE FOREST NC
27587-7136
US

V. Phone/Fax

Practice location:
  • Phone: 914-584-8350
  • Fax:
Mailing address:
  • Phone: 914-584-8350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CRYSTAL HOTCHKIN
Title or Position: THERAPIST
Credential: LCSW
Phone: 914-584-8350