Provider Demographics
NPI:1396887154
Name:HAYES, MARI K (PHD)
Entity type:Individual
Prefix:DR
First Name:MARI
Middle Name:K
Last Name:HAYES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6306 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64113-2314
Mailing Address - Country:US
Mailing Address - Phone:734-673-0082
Mailing Address - Fax:
Practice Address - Street 1:6306 WALNUT ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64113-2314
Practice Address - Country:US
Practice Address - Phone:734-673-0082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPYT0063103T00000X
MO2005028847103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR83355OtherARK BLUE SHIELD
MO497192906Medicaid
MO220151333Medicare PIN