Provider Demographics
NPI:1477282473
Name:HAYDEN, GRACE KELLY (LMSW)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:KELLY
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 GURNEY DR
Mailing Address - Street 2:
Mailing Address - City:FRUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21826-1314
Mailing Address - Country:US
Mailing Address - Phone:410-353-7518
Mailing Address - Fax:
Practice Address - Street 1:809 EASTERN SHORE DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-5934
Practice Address - Country:US
Practice Address - Phone:844-224-5264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28647104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker