Provider Demographics
NPI:1659732238
Name:HAYDEN, CASEY
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 N BUFFALO DR
Mailing Address - Street 2:UNIT B
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-0311
Mailing Address - Country:US
Mailing Address - Phone:702-877-2520
Mailing Address - Fax:702-877-2521
Practice Address - Street 1:331 N BUFFALO DR
Practice Address - Street 2:UNIT B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-0311
Practice Address - Country:US
Practice Address - Phone:702-877-2520
Practice Address - Fax:702-877-2521
Is Sole Proprietor?:No
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLABA0011103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV35229430OtherPRIVATE INSURANCE