Provider Demographics
NPI:1336419605
Name:HAYES, JOSEPH (CASAC, MPA)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:HAYES
Suffix:
Gender:M
Credentials:CASAC, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-5222
Mailing Address - Country:US
Mailing Address - Phone:718-398-0800
Mailing Address - Fax:
Practice Address - Street 1:202 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-5222
Practice Address - Country:US
Practice Address - Phone:718-398-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20773103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst