Healthcare Provider Details

I. General information

NPI: 1790050532
Provider Name (Legal Business Name): CHRISTINA ANN ACHESON-HAYES L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2012
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4724 S DORY TRL
FLAGSTAFF AZ
86005-8374
US

IV. Provider business mailing address

4724 S DORY TRL
FLAGSTAFF AZ
86005-8374
US

V. Phone/Fax

Practice location:
  • Phone: 631-793-7728
  • Fax: 631-793-7728
Mailing address:
  • Phone: 631-793-7728
  • Fax: 631-793-7728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number079243-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number19621
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: