Provider Demographics
NPI:1548030752
Name:HAYES, COURTNEY LYNN (LMSW)
Entity type:Individual
Prefix:MISS
First Name:COURTNEY
Middle Name:LYNN
Last Name:HAYES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 TEEBURN BLVD
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-6118
Mailing Address - Country:US
Mailing Address - Phone:607-237-5425
Mailing Address - Fax:
Practice Address - Street 1:3001 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ENDWELL
Practice Address - State:NY
Practice Address - Zip Code:13760-5843
Practice Address - Country:US
Practice Address - Phone:607-754-2660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY110415104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker