Healthcare Provider Details

I. General information

NPI: 1255905360
Provider Name (Legal Business Name): HEATHER NOEL HAYES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2021
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 THOMAS JONES WAY
EXTON PA
19341-2553
US

IV. Provider business mailing address

2 TRADITION LN
DOWNINGTOWN PA
19335-1316
US

V. Phone/Fax

Practice location:
  • Phone: 484-888-4553
  • Fax:
Mailing address:
  • Phone: 484-888-4553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW021227
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: