Provider Demographics
NPI:1205044872
Name:HAYES, SHANNON N (PSYD, LMHC, LPC)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:N
Last Name:HAYES
Suffix:
Gender:F
Credentials:PSYD, LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 700305
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96709-0305
Mailing Address - Country:US
Mailing Address - Phone:832-661-6565
Mailing Address - Fax:808-720-6239
Practice Address - Street 1:941 KAMEHAMEHA HWY STE 204
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-2516
Practice Address - Country:US
Practice Address - Phone:832-661-6565
Practice Address - Fax:808-720-6239
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
AK538101YP2500X
HI482101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional