Provider Demographics
NPI:1275240129
Name:HAYDEN, VALERIE (LICASW)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:LICASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32744 SE COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:BLACK DIAMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98010-5068
Mailing Address - Country:US
Mailing Address - Phone:901-355-6606
Mailing Address - Fax:
Practice Address - Street 1:32744 SE COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:BLACK DIAMOND
Practice Address - State:WA
Practice Address - Zip Code:98010-5068
Practice Address - Country:US
Practice Address - Phone:901-355-6606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC61241718104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty