Provider Demographics
NPI:1255313557
Name:HAYES GRIFFIN, BERNADETTE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BERNADETTE
Middle Name:
Last Name:HAYES GRIFFIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-2537
Mailing Address - Country:US
Mailing Address - Phone:845-735-3881
Mailing Address - Fax:
Practice Address - Street 1:180 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-2537
Practice Address - Country:US
Practice Address - Phone:845-735-3881
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR01533911041C0700X
NJ445C012903001041C0700X
NY11434CASAC1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP1313765OtherOXFORD
N41191OtherBCBS
NJP1313765OtherOXFORD
NY5878209OtherAETNA
NJ5878209OtherAETNA
NJP1313765OtherOXFORD