Provider Demographics
NPI:1376207209
Name:HAYES-JONES, KATIESHA LOUELLA (LCSWA)
Entity Type:Individual
Prefix:
First Name:KATIESHA
Middle Name:LOUELLA
Last Name:HAYES-JONES
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 DAVIS AVE
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-6002
Mailing Address - Country:US
Mailing Address - Phone:910-640-1038
Mailing Address - Fax:
Practice Address - Street 1:732 DAVIS AVE
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-6002
Practice Address - Country:US
Practice Address - Phone:910-640-1038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0170691041C0700X
NCLCAS-27578101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)