Provider Demographics
NPI:1255433181
Name:HAYES-ENGLAND, KATHRYN MICHELE (LCSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MICHELE
Last Name:HAYES-ENGLAND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 WILSHIRE BLVD
Mailing Address - Street 2:SUITE #104
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-1500
Mailing Address - Country:US
Mailing Address - Phone:310-395-1725
Mailing Address - Fax:310-395-1725
Practice Address - Street 1:613 WILSHIRE BLVD
Practice Address - Street 2:SUITE #104
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-1500
Practice Address - Country:US
Practice Address - Phone:310-395-1725
Practice Address - Fax:310-395-1725
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15198101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health