Provider Demographics
NPI:1285086314
Name:HAYES, JOHN (LACMH)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:HAYES
Suffix:
Gender:M
Credentials:LACMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 S BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-1850
Mailing Address - Country:US
Mailing Address - Phone:302-319-8775
Mailing Address - Fax:
Practice Address - Street 1:410 S BEDFORD ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-1850
Practice Address - Country:US
Practice Address - Phone:302-319-8775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE0000095101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health