Provider Demographics
NPI:1053462416
Name:SPENCER HAYES, LINN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINN
Middle Name:
Last Name:SPENCER HAYES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 ORCHARD PARK DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-5738
Mailing Address - Country:US
Mailing Address - Phone:518-831-9456
Mailing Address - Fax:
Practice Address - Street 1:4 FRANKLIN SQ
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2141
Practice Address - Country:US
Practice Address - Phone:518-583-0963
Practice Address - Fax:518-583-0369
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4093311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01733128Medicaid
NY01733128Medicaid