Healthcare Provider Details

I. General information

NPI: 1982973392
Provider Name (Legal Business Name): KATIE ELIZABETH HAYES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2011
Last Update Date: 12/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 VETERANS DR
LEXINGTON KY
40502-2235
US

IV. Provider business mailing address

104 ALLISON CIR
NICHOLASVILLE KY
40356-2925
US

V. Phone/Fax

Practice location:
  • Phone: 859-281-3939
  • Fax:
Mailing address:
  • Phone: 859-230-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3552
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: