Basic Information
| Provider Information | |||||||||
| NPI: | 1770714461 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAYES | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | KATE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MA, LCAS, LPCS,CCS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10835 FLAT IRON RD | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282264646 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286060667 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4949 ALBEMARLE RD STE AANDB | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282056629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7045324262 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2009 | ||||||||
| LastUpdateDate: | 06/29/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 7290 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Professional | 101YA0400X | 1450 | NC | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.