Provider Demographics
NPI:1841633955
Name:HAYMOND, DAVID C (ACMHC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:HAYMOND
Suffix:
Gender:M
Credentials:ACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 S DENVER ST
Mailing Address - Street 2:215
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-3000
Mailing Address - Country:US
Mailing Address - Phone:801-521-4227
Mailing Address - Fax:801-359-0777
Practice Address - Street 1:352 S DENVER ST
Practice Address - Street 2:215
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-3000
Practice Address - Country:US
Practice Address - Phone:801-521-4227
Practice Address - Fax:801-359-0777
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8552153-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health