Provider Demographics
NPI:1902073117
Name:HAYDEN, KATHLEEN (LPC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-5811
Mailing Address - Country:US
Mailing Address - Phone:215-628-2492
Mailing Address - Fax:
Practice Address - Street 1:727 WELSH RD
Practice Address - Street 2:STE 202
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-6357
Practice Address - Country:US
Practice Address - Phone:215-914-2119
Practice Address - Fax:215-914-1663
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000315101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional