Provider Demographics
NPI:1164248753
Name:HAYES, KATHERINE HUMMEL (LAPC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:HUMMEL
Last Name:HAYES
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:HUMMEL
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAPC
Mailing Address - Street 1:98 JACQUELYN DR
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-3644
Mailing Address - Country:US
Mailing Address - Phone:404-444-8818
Mailing Address - Fax:
Practice Address - Street 1:1800 NORTHSIDE FORSYTH DR STE 460
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-8483
Practice Address - Country:US
Practice Address - Phone:404-444-8818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC010006101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health