Provider Demographics
NPI:1144744665
Name:LEWIS, HAYDEN GUYE (CDCA)
Entity Type:Individual
Prefix:MR
First Name:HAYDEN
Middle Name:GUYE
Last Name:LEWIS
Suffix:
Gender:M
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6602 DORR ST APT 204
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-4238
Mailing Address - Country:US
Mailing Address - Phone:240-644-7366
Mailing Address - Fax:
Practice Address - Street 1:6602 DORR ST APT 204
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-4238
Practice Address - Country:US
Practice Address - Phone:240-644-7366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator