Healthcare Provider Details

I. General information

NPI: 1841465903
Provider Name (Legal Business Name): CATHERINE LYNN HAYMAN MA/LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 10/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24178 FIRST AVENUE, STE 2
SIREN WI
54872-0381
US

IV. Provider business mailing address

PO BOX 381
SIREN WI
54872-0381
US

V. Phone/Fax

Practice location:
  • Phone: 715-349-8913
  • Fax: 715-349-8981
Mailing address:
  • Phone: 715-349-8913
  • Fax: 715-349-8981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: