Healthcare Provider Details

I. General information

NPI: 1891642815
Provider Name (Legal Business Name): CINDY HAYSLIP CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

765 N DETROIT ST
XENIA OH
45385-1960
US

IV. Provider business mailing address

127 S SOUTH ST APT 5
WILMINGTON OH
45177-2358
US

V. Phone/Fax

Practice location:
  • Phone: 866-534-2639
  • Fax: 800-480-7578
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCAPRE.196204
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: