Provider Demographics
NPI:1851278220
Name:HAYDEL, ELIZABETH (BS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HAYDEL
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 PRINCETON WOODS LOOP
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6601
Mailing Address - Country:US
Mailing Address - Phone:337-322-9042
Mailing Address - Fax:
Practice Address - Street 1:3999 COMMONS DR W STE K
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-8446
Practice Address - Country:US
Practice Address - Phone:337-322-9042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty