MEDICARE: KRISTEN D HAYES MSW, LCSW

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	001294	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	14187456	OTHER	MO	CAQH

General Provider Information

NPI Number	:	1831140631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN D HAYES MSW, LCSW

Provider Business Mailing Address
First Line	:	1411 ROLLINS RD
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65203-2376
Country	:	US
Telephone Number	:	573-449-5999
Fax Number	:

Provider Business Practice Location Address
First Line	:	1411 ROLLINS RD
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65203-2376
Country	:	US
Telephone Number	:	573-449-5999
Fax Number	:

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	03/17/2020

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