Healthcare Provider Details

I. General information

NPI: 1194633248
Provider Name (Legal Business Name): LISA CHERIE HAYES-EVANS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 YALE AVE
STRATFORD NJ
08084-1247
US

IV. Provider business mailing address

158 MYRTLE AVE
NEPTUNE NJ
07753-4764
US

V. Phone/Fax

Practice location:
  • Phone: 856-352-5424
  • Fax:
Mailing address:
  • Phone: 732-677-6412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00436200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: