Provider Demographics
NPI:1356989842
Name:HAYES, ELIZABETH ANSLEY (LPCA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANSLEY
Last Name:HAYES
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 LOVETT ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-3340
Mailing Address - Country:US
Mailing Address - Phone:770-294-5182
Mailing Address - Fax:
Practice Address - Street 1:2100 W CORNWALLIS DR STE O
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7015
Practice Address - Country:US
Practice Address - Phone:336-337-5469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-15
Last Update Date:2019-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA15341101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor