Healthcare Provider Details

I. General information

NPI: 1043829807
Provider Name (Legal Business Name): LEIGH STEWART HAYDEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2020
Last Update Date: 07/28/2020
Certification Date: 07/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 SW PALM CITY RD
STUART FL
34994-2820
US

IV. Provider business mailing address

828 SW PALM CITY RD
STUART FL
34994-2820
US

V. Phone/Fax

Practice location:
  • Phone: 772-341-7337
  • Fax: 772-678-6513
Mailing address:
  • Phone: 772-341-7337
  • Fax: 772-678-6513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16036
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: