Provider Demographics
NPI:1447524848
Name:HAYWOOD, LINDA A (MSW)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:HAYWOOD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40315 MICHIGAN AVE # 1046
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-2908
Mailing Address - Country:US
Mailing Address - Phone:734-799-1819
Mailing Address - Fax:
Practice Address - Street 1:35420 JOHN ST # 1046
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:MI
Practice Address - Zip Code:48184-2362
Practice Address - Country:US
Practice Address - Phone:734-444-7579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-02
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010886351041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical