Healthcare Provider Details

I. General information

NPI: 1356672000
Provider Name (Legal Business Name): MICHAEL EDWARD HAYS ACSW, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2010
Last Update Date: 02/26/2022
Certification Date: 02/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 14TH ST SW
ALBUQUERQUE NM
87102-2827
US

IV. Provider business mailing address

417 14TH ST SW
ALBUQUERQUE NM
87102-2827
US

V. Phone/Fax

Practice location:
  • Phone: 505-331-4705
  • Fax:
Mailing address:
  • Phone: 505-331-4705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-09305
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: