Provider Demographics
NPI:1518142983
Name:HAYES, HUGH LEON (LCSW, CADC II)
Entity Type:Individual
Prefix:MR
First Name:HUGH
Middle Name:LEON
Last Name:HAYES
Suffix:
Gender:M
Credentials:LCSW, CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10515 BALBOA BLVD STE 376
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-6397
Mailing Address - Country:US
Mailing Address - Phone:818-968-9165
Mailing Address - Fax:
Practice Address - Street 1:40905 168TH ST E
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-7108
Practice Address - Country:US
Practice Address - Phone:818-968-9165
Practice Address - Fax:661-264-9162
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA580078-92101YA0400X
CA88608104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1518142983Medicaid