MEDICARE: LARA HAYDEN LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LW60629606	WA

General Provider Information

NPI Number	:	1104367002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARA HAYDEN LICSW

Provider Business Mailing Address
First Line	:	300 LENORA ST # 576
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98121-2411
Country	:	US
Telephone Number	:	206-657-7608
Fax Number	:	206-456-0736

Provider Business Practice Location Address
First Line	:	300 LENORA ST # 576
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98121-2411
Country	:	US
Telephone Number	:	206-657-7608
Fax Number	:	206-456-0736

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2017
Last Update Date	:	10/15/2025

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Directions to “ LARA HAYDEN LICSW” Practice Location

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