=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356224208
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATIE HATCH LICSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2025
-----------------------------------------------------
Last Update Date | 01/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 HEALTHY WAY
-----------------------------------------------------
City | OLIVIA
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56277-1117
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 320-523-1460
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8170 33RD AVE S # MS 21110Q
-----------------------------------------------------
City | BLOOMINGTON
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55425-4516
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 25381
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------