Provider Demographics
NPI:1235345398
Name:HAYES, JODEE ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:JODEE
Middle Name:ANN
Last Name:HAYES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JODEE
Other - Middle Name:A
Other - Last Name:GERRITSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PLCSW
Mailing Address - Street 1:611 WESTLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-4728
Mailing Address - Country:US
Mailing Address - Phone:402-984-9301
Mailing Address - Fax:
Practice Address - Street 1:611 WESTLAWN AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-4728
Practice Address - Country:US
Practice Address - Phone:402-984-9301
Practice Address - Fax:308-382-5315
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3341101YM0800X
NE811101YM0800X
NE12671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026321900Medicaid
NE10026321900Medicaid