Provider Demographics
NPI:1174636864
Name:HAYES, RONDA J (LPC)
Entity Type:Individual
Prefix:PROF
First Name:RONDA
Middle Name:J
Last Name:HAYES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 W AVENUE N
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-5094
Mailing Address - Country:US
Mailing Address - Phone:325-944-9100
Mailing Address - Fax:325-949-8744
Practice Address - Street 1:2406 W AVENUE N
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-5094
Practice Address - Country:US
Practice Address - Phone:325-944-9100
Practice Address - Fax:325-949-8744
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19381101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7114LCOtherBLUE CROSS BLUE SHIELD OF