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Individual

MR. CLIFTON HATCHERSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
445 WINN WAY, 5247 RUNNING DOE DRIVE, DECATUR, GA 30030-1707
(404) 289-8445
(404) 298-8288
Mailing address
445 WINN WAY, 5247 RUNNING DOE DRIVE, DECATUR, GA 30030-1707
(404) 289-8445
(404) 298-8288

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW002174
GA
1041C0700X
Clinical Social Worker
PRO024609-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
80BBFRS
MEDICARE PROVIDER NUMBER
GA
Enumeration date
05/23/2008
Last updated
05/23/2008
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