Provider Demographics
NPI:1003691536
Name:HAYES, HUBERT DORN II (LSW, CDCA)
Entity Type:Individual
Prefix:
First Name:HUBERT
Middle Name:DORN
Last Name:HAYES
Suffix:II
Gender:M
Credentials:LSW, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5603 MEDINAH DR APT D
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-5302
Mailing Address - Country:US
Mailing Address - Phone:614-869-9598
Mailing Address - Fax:
Practice Address - Street 1:813 BRYDEN RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-1759
Practice Address - Country:US
Practice Address - Phone:614-392-7253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.178359101YA0400X
OHS.2309243101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)