Provider Demographics
NPI:1780273656
Name:HAYES, ALYSSA M (MS, ATR-BC,)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:M
Last Name:HAYES
Suffix:
Gender:F
Credentials:MS, ATR-BC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 CARLISLE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-3217
Mailing Address - Country:US
Mailing Address - Phone:757-576-9192
Mailing Address - Fax:
Practice Address - Street 1:830 SOUTHLAKE BLVD STE B
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3935
Practice Address - Country:US
Practice Address - Phone:804-466-3130
Practice Address - Fax:804-466-3130
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
18-567221700000X
VA704010367101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist