Jessyca Dameron Hayward, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW18875 Issued in FL

Practice address

3890 Dunn Ave Ste 1104
Jacksonville, FL 32218-6432

Phone

(904) 765-0664

NPI assigned

Jan 8, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Jessyca Hayward Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mindful Culinary Therapy, LLC

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1164183430
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1366915894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12134 BLACKFOOT CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322233235",
            "telephone_number": "904-885-3839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 DUNN AVE STE 1104",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322186432",
            "telephone_number": "904-765-0664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1480 Delowe Dr SW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303113318",
            "country_code": "US",
            "telephone_number": "404-612-7114",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Lanier Ave W Ste 103",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "GA",
            "postal_code": "302147640",
            "country_code": "US",
            "telephone_number": "404-800-4002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYWARD",
        "first_name": "JESSYCA",
        "middle_name": "DAMERON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-08",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007582",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW18875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366915894",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366915894",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jhayward@rightpathbehavior.com",
            "affiliation": "Y",
            "affiliationName": "Right Path Behavioral Health Services, LLC.",
            "address_1": "3890 Dunn Ave Ste 1104",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322186432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSYCA",
            "last_name": "HAYWARD",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Heather Stubbs Haynes
• Lauren Haynes
• Melody Haynes
• Jessica Hays, APRN, FNP-C
• Ana Curcic Hayward, PA-C
• Tyeisha Hayward, CNA
• Haywood Helping Hands
• Linda Haywood, APRN
• Tanya Haywood
• Anne Hazen, APRN

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.