Healthcare Provider Details

I. General information

NPI: 1144848045
Provider Name (Legal Business Name): HYATT COUNSELLING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2020
Last Update Date: 07/12/2020
Certification Date: 07/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 CONGRESS ST S
YORK SC
29745-1837
US

IV. Provider business mailing address

1539 TIANA WAY
ROCK HILL SC
29732-7605
US

V. Phone/Fax

Practice location:
  • Phone: 803-307-4647
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE HYATT
Title or Position: PRESIDENT
Credential:
Phone: 803-370-8852