Provider Demographics
NPI:1982364865
Name:HAYES, DYLANN ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:DYLANN
Middle Name:ELIZABETH
Last Name:HAYES
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 1:6777 CAMP BOWIE BLVD STE 229
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-7157
Mailing Address - Country:US
Mailing Address - Phone:682-703-1311
Mailing Address - Fax:817-887-1694
Practice Address - Street 1:6777 CAMP BOWIE BLVD STE 229
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-7157
Practice Address - Country:US
Practice Address - Phone:682-703-1311
Practice Address - Fax:817-887-1694
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65933101YM0800X, 104100000X, 1041C0700X
101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker