Healthcare Provider Details

I. General information

NPI: 1972993053
Provider Name (Legal Business Name): JENNIFER HAYES LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2015
Last Update Date: 04/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 1/2 OGDEN ST STE 4
SOMERSET KY
42501-1888
US

IV. Provider business mailing address

452 TWIN RIVERS CIR
BRONSTON KY
42518-9474
US

V. Phone/Fax

Practice location:
  • Phone: 606-802-0533
  • Fax:
Mailing address:
  • Phone: 606-802-0533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number162690
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: