Provider Demographics
NPI:1801665328
Name:HAYES, KEVIN L
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:L
Last Name:HAYES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:KEVIN
Other - Middle Name:L
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PEER SUPPORT
Mailing Address - Street 1:12824 CUB RUN HWY
Mailing Address - Street 2:
Mailing Address - City:CUB RUN
Mailing Address - State:KY
Mailing Address - Zip Code:42729-8116
Mailing Address - Country:US
Mailing Address - Phone:270-218-5920
Mailing Address - Fax:
Practice Address - Street 1:12824 CUB RUN HWY
Practice Address - Street 2:
Practice Address - City:CUB RUN
Practice Address - State:KY
Practice Address - Zip Code:42729-8116
Practice Address - Country:US
Practice Address - Phone:270-218-5920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist