Provider Demographics
NPI:1871845784
Name:HAYES, SONDRA DENISE (LPC, LMFT, LAC, CCDP)
Entity Type:Individual
Prefix:
First Name:SONDRA
Middle Name:DENISE
Last Name:HAYES
Suffix:
Gender:F
Credentials:LPC, LMFT, LAC, CCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1481
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-1481
Mailing Address - Country:US
Mailing Address - Phone:225-278-2079
Mailing Address - Fax:
Practice Address - Street 1:3718 HIGHWAY 10
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:LA
Practice Address - Zip Code:70748-6235
Practice Address - Country:US
Practice Address - Phone:225-278-2079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2942101Y00000X, 101YM0800X, 101YP2500X
LA967101YA0400X
LA1072101YA0400X
LA1125106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist