MEDICARE: LUKE HAYDEN HATFIELD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	1293	KY
2	101YP2500X	Professional Counselor	0577	KY
3	101YP2500X	Professional Counselor	1293	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649477464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUKE HAYDEN HATFIELD

Provider Business Mailing Address
First Line	:	PO BOX 4237
Second Line	:
City	:	LEITCHFIELD
State	:	KY
Zip	:	42755-4237
Country	:	US
Telephone Number	:	270-230-1777
Fax Number	:	270-679-0838

Provider Business Practice Location Address
First Line	:	346 S MAIN ST
Second Line	:
City	:	LEITCHFIELD
State	:	KY
Zip	:	42754-1428
Country	:	US
Telephone Number	:	270-230-1777
Fax Number	:	270-679-0838

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	02/12/2024

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Directions to “ LUKE HAYDEN HATFIELD ” Practice Location

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