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NPI Code Detail

MEDICARE: ALYSSA MARIE HAYES LSW, MSW

MEDICARE: ALYSSA MARIE HAYES LSW, MSW
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
11041C0700XClinical Social Worker
21041C0700XClinical Social WorkerLSW.0009922296CO
3104100000XSocial WorkerLSW.0009922296CO

General Provider Information

NPI Number : 1528463692
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA MARIE HAYES LSW, MSW
Provider Business Mailing Address
First Line : 208 RACQUETTE DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-4851
Country : US
Telephone Number : 970-498-0709
Fax Number : 888-965-4615
Provider Business Practice Location Address
First Line : 208 RACQUETTE DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-4851
Country : US
Telephone Number : 970-498-0709
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2014
Last Update Date : 12/17/2024

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