Healthcare Provider Details

I. General information

NPI: 1659206910
Provider Name (Legal Business Name): HAYLIE LAFICA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20325 N 51ST AVE STE 100
GLENDALE AZ
85308-5665
US

IV. Provider business mailing address

20986 N 66TH LN
GLENDALE AZ
85308-6652
US

V. Phone/Fax

Practice location:
  • Phone: 442-888-0000
  • Fax:
Mailing address:
  • Phone: 442-888-4960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLAC-23193
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: