Provider Demographics
NPI:1609008374
Name:HAYES, LARRY SR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:
Last Name:HAYES
Suffix:SR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3740 FAIRMONT DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-4711
Mailing Address - Country:US
Mailing Address - Phone:504-289-9876
Mailing Address - Fax:504-942-1608
Practice Address - Street 1:3740 FAIRMONT DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-4711
Practice Address - Country:US
Practice Address - Phone:504-289-9876
Practice Address - Fax:504-942-1608
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-14
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA31841041C0700X
GACSW0035441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical