Healthcare Provider Details

I. General information

NPI: 1548525215
Provider Name (Legal Business Name): ALYSIA MARIE HAYS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALYSIA MARIE GIBBS LCSW

II. Dates (important events)

Enumeration Date: 07/09/2012
Last Update Date: 05/10/2021
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 H ST
EUREKA CA
95501-1026
US

IV. Provider business mailing address

670 9TH STREET SUITE 203
ARCATA CA
95521-6249
US

V. Phone/Fax

Practice location:
  • Phone: 707-443-4666
  • Fax: 707-441-4833
Mailing address:
  • Phone: 707-826-8633
  • Fax: 707-826-8638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number69387
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: