Provider Demographics
NPI:1174656508
Name:HAYDEN, JOSEPH JEAN
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:JEAN
Last Name:HAYDEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BENWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26031-1121
Mailing Address - Country:US
Mailing Address - Phone:304-232-6455
Mailing Address - Fax:304-234-3511
Practice Address - Street 1:2121 EOFF ST
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3805
Practice Address - Country:US
Practice Address - Phone:304-234-3570
Practice Address - Fax:304-234-3511
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV398103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVPENDINGMedicare ID - Type Unspecified