Healthcare Provider Details

I. General information

NPI: 1053705343
Provider Name (Legal Business Name): DESIREE HATTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2015
Last Update Date: 03/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19-11 VALLEY RD
DREXEL HILL PA
19026-5400
US

IV. Provider business mailing address

19-11 VALLEY RD
DREXEL HILL PA
19026-5400
US

V. Phone/Fax

Practice location:
  • Phone: 610-608-0260
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW016450
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: