Provider Demographics
NPI:1568128205
Name:HAYES, VINCENT ADARRYL
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:ADARRYL
Last Name:HAYES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 LEGACY CT APT 150
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-5111
Mailing Address - Country:US
Mailing Address - Phone:252-469-9390
Mailing Address - Fax:
Practice Address - Street 1:3106 S MEMORIAL DR STE B
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-6765
Practice Address - Country:US
Practice Address - Phone:252-916-6048
Practice Address - Fax:252-371-1655
Is Sole Proprietor?:No
Enumeration Date:2021-11-16
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0171361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical