Healthcare Provider Details

I. General information

NPI: 1235190703
Provider Name (Legal Business Name): MICHAEL A HAYES L.C.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9105 FRANKLIN SQUARE DR SUITES 102/103
BALTIMORE MD
21237-3930
US

IV. Provider business mailing address

9105 FRANKLIN SQUARE DR SUITES 102/103
BALTIMORE MD
21237-3930
US

V. Phone/Fax

Practice location:
  • Phone: 443-777-7878
  • Fax:
Mailing address:
  • Phone: 443-777-7878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: