Provider Demographics
NPI:1518414713
Name:HAYES, KEAIRRA
Entity Type:Individual
Prefix:
First Name:KEAIRRA
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1931 NOTTINGHAM WAY
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3554
Mailing Address - Country:US
Mailing Address - Phone:609-882-1898
Mailing Address - Fax:609-882-3880
Practice Address - Street 1:1216 ARCH ST FL 6
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-2835
Practice Address - Country:US
Practice Address - Phone:215-981-3356
Practice Address - Fax:215-558-6604
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker