Provider Demographics
NPI:1053655803
Name:HAYDEN, CARL THOMAS (RMHCI)
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:THOMAS
Last Name:HAYDEN
Suffix:
Gender:M
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9436 N US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-6395
Mailing Address - Country:US
Mailing Address - Phone:321-446-3409
Mailing Address - Fax:
Practice Address - Street 1:9436 N US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-6395
Practice Address - Country:US
Practice Address - Phone:321-446-3409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-18
Last Update Date:2012-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL12000144562172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker