Provider Demographics
NPI:1083064448
Name:HAYWOOD, ERIC BRUCE (BS, CAADC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:BRUCE
Last Name:HAYWOOD
Suffix:
Gender:M
Credentials:BS, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 CASS ST
Mailing Address - Street 2:SUITE 2A & 2D
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2589
Mailing Address - Country:US
Mailing Address - Phone:231-409-5594
Mailing Address - Fax:231-943-2590
Practice Address - Street 1:940 E 8TH ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-2893
Practice Address - Country:US
Practice Address - Phone:231-409-5594
Practice Address - Fax:231-943-2590
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator