Provider Demographics
NPI:1336677897
Name:HAYES, ANDREA MARSH (LCMHC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARSH
Last Name:HAYES
Suffix:
Gender:F
Credentials:LCMHC
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 27070
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-5034
Mailing Address - Country:US
Mailing Address - Phone:910-689-6558
Mailing Address - Fax:
Practice Address - Street 1:2106 HOPE MILLS RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4226
Practice Address - Country:US
Practice Address - Phone:910-502-3162
Practice Address - Fax:910-330-9003
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11247101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health