Provider Demographics
NPI:1770681678
Name:HAYWARD, SUSAN M (LMFT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:HAYWARD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 GRANDVIEW AVE
Mailing Address - Street 2:WATERBURY HOSPITAL - BEHAVIORAL HEALTH
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708
Mailing Address - Country:US
Mailing Address - Phone:203-573-6103
Mailing Address - Fax:203-573-7240
Practice Address - Street 1:88 GRANDVIEW AVE
Practice Address - Street 2:WATERBURY HOSPITAL - BEHAVIORAL HEALTH
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708
Practice Address - Country:US
Practice Address - Phone:203-573-6103
Practice Address - Fax:203-573-7240
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000737106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist