Provider Demographics
NPI:1104990183
Name:HAYES, CONSTANCE LYNN (MSW)
Entity type:Individual
Prefix:MS
First Name:CONSTANCE
Middle Name:LYNN
Last Name:HAYES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:CONSTANCE
Other - Middle Name:LYNN
Other - Last Name:KEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:24 FRONT ST
Mailing Address - Street 2:COASTAL COUNSELING ASSOCIATES
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-6221
Mailing Address - Country:US
Mailing Address - Phone:603-778-0505
Mailing Address - Fax:603-772-6761
Practice Address - Street 1:24 FRONT STREET
Practice Address - Street 2:COASTAL COUNSELING ASSOCIATES
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-6221
Practice Address - Country:US
Practice Address - Phone:603-778-0505
Practice Address - Fax:603-772-6761
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH245104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE5209Medicare ID - Type Unspecified
NH30422305Medicare ID - Type Unspecified