Healthcare Provider Details

I. General information

NPI: 1306433867
Provider Name (Legal Business Name): CHEYENNE KAYLYNN HAYES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2020
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N MUSTANG RD STE G
MUSTANG OK
73064-7044
US

IV. Provider business mailing address

501 N MUSTANG RD STE G
MUSTANG OK
73064-7044
US

V. Phone/Fax

Practice location:
  • Phone: 572-276-6122
  • Fax:
Mailing address:
  • Phone: 672-276-6122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13335
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: