Provider Demographics
NPI:1447326665
Name:HAYES WHITFIELD, GLADYS (LPCC SUPV, NCC)
Entity type:Individual
Prefix:
First Name:GLADYS
Middle Name:
Last Name:HAYES WHITFIELD
Suffix:
Gender:F
Credentials:LPCC SUPV, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 YOUNGSTOWN POLAND RD
Mailing Address - Street 2:
Mailing Address - City:STRUTHERS
Mailing Address - State:OH
Mailing Address - Zip Code:44471-1058
Mailing Address - Country:US
Mailing Address - Phone:330-755-2147
Mailing Address - Fax:330-755-2846
Practice Address - Street 1:420 YOUNGSTOWN POLAND RD
Practice Address - Street 2:
Practice Address - City:STRUTHERS
Practice Address - State:OH
Practice Address - Zip Code:44471-1058
Practice Address - Country:US
Practice Address - Phone:330-755-2147
Practice Address - Fax:330-755-2846
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0004181-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH29664954002OtherMED MUTUAL 1
OH000000306230OtherANTHEM BLUE CROSS