Provider Demographics
NPI:1083374573
Name:HAYAS, SAMANTHA SENAIDA (LCSW)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:SENAIDA
Last Name:HAYAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:S
Other - Last Name:MONTANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1957 CALLE CRISTO
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-8475
Mailing Address - Country:US
Mailing Address - Phone:505-920-4771
Mailing Address - Fax:
Practice Address - Street 1:5201 VENICE AVE NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-2337
Practice Address - Country:US
Practice Address - Phone:505-916-2007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-118401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical