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General NPI Number Information
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NPI Number | 1548155682
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Entity Type | Individual
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Provider Name | HAYDEN LAWLESS
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Gender | Male
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Dates
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Enumeration Date | 06/10/2025
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 1523 LONGBRANCH AVE
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City | GROVER BEACH
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State | CA
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Zip | 93433-2508
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Country | US
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Telephone | 805-473-7080
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 16
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City | MORRO BAY
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State | CA
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Zip | 93443-0016
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Country | US
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Telephone |
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMFT147946
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License Number State | CA
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