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General NPI Number Information
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NPI Number | 1073022513
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Entity Type | Individual
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Provider Name | GWENDOLYN ELAINE HAYES LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/27/2017
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Last Update Date | 11/08/2022
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Provider Practice Location Address
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Address Line | 35 TALCOTTVILLE RD STE 10
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City | VERNON
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State | CT
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Zip | 06066-5261
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Country | US
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Telephone | 860-558-2554
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Fax |
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Provider Business Mailing Address
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Address Line | 35 TALCOTTVILLE ROAD, #1031 SUITE 10
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City | VERNON
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State | CT
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Zip | 06066-3600
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Country | US
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Telephone | 860-558-2554
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Fax | 860-454-5024
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 009786
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License Number State | CT
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