Provider Demographics
NPI:1063975035
Name:HEYWARD, CARLA HAYLEY
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:HAYLEY
Last Name:HEYWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 MARCUS GARVEY BLVD STE 420
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-5303
Mailing Address - Country:US
Mailing Address - Phone:917-966-5255
Mailing Address - Fax:917-966-5254
Practice Address - Street 1:7 MARCUS GARVEY BLVD STE 420
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5303
Practice Address - Country:US
Practice Address - Phone:917-966-5255
Practice Address - Fax:917-966-5254
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-08
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker