Provider Demographics
NPI:1093364036
Name:HAYDEN, HEATHER M (LCMFT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 S GREEN ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211-2813
Mailing Address - Country:US
Mailing Address - Phone:316-737-9907
Mailing Address - Fax:
Practice Address - Street 1:200 N BROADWAY AVE FL 5
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-2301
Practice Address - Country:US
Practice Address - Phone:316-737-9907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03117106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist