Provider Demographics
NPI:1053655258
Name:HAYWARD, RITA (LPC, MHSP)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:
Last Name:HAYWARD
Suffix:
Gender:F
Credentials:LPC, MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:548 SPRINGMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-1555
Mailing Address - Country:US
Mailing Address - Phone:615-541-2868
Mailing Address - Fax:
Practice Address - Street 1:3000 BUSINESS PARK CIR
Practice Address - Street 2:400
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-3500
Practice Address - Country:US
Practice Address - Phone:615-448-6799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-12
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2043101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health