Provider Demographics
NPI:1700237096
Name:HAYWARD, DAVID DEXTER (MS, MCAP, LMHC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:DEXTER
Last Name:HAYWARD
Suffix:
Gender:M
Credentials:MS, MCAP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7551 WILES RD STE 105A
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2064
Mailing Address - Country:US
Mailing Address - Phone:754-265-2702
Mailing Address - Fax:754-240-4953
Practice Address - Street 1:7551 WILES RD STE 105A
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-2064
Practice Address - Country:US
Practice Address - Phone:754-971-6002
Practice Address - Fax:754-240-4953
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLADC-011482-2015101YA0400X
FLMH14560101YM0800X
FLMH14555101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL145560OtherFLORIDA DEPARTMENT OF HEALTH