Provider Demographics
NPI:1003897984
Name:HAYDEN, DEBORA J (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBORA
Middle Name:J
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12700 FEE FEE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-4402
Mailing Address - Country:US
Mailing Address - Phone:314-566-9219
Mailing Address - Fax:314-989-9333
Practice Address - Street 1:12700 FEE FEE RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-4402
Practice Address - Country:US
Practice Address - Phone:314-989-9449
Practice Address - Fax:314-989-9333
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0009701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO493380018Medicaid
MO75338005Medicaid