Provider Demographics
NPI:1043752975
Name:HAYES, HEATHER R (LPC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:R
Last Name:HAYES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 BUFORD HWY # 215-335
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-1266
Mailing Address - Country:US
Mailing Address - Phone:800-219-0570
Mailing Address - Fax:
Practice Address - Street 1:327 DAHLONEGA ST STE A1901
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-8220
Practice Address - Country:US
Practice Address - Phone:800-219-0570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-09
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC001592101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional