Healthcare Provider Details

I. General information

NPI: 1770272080
Provider Name (Legal Business Name): CHRISTA NICOLE HANEY MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2023
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 EDGEWOOD HILLS RD
OAK HILL WV
25901-9324
US

IV. Provider business mailing address

35 EDGEWOOD HILLS RD
OAK HILL WV
25901-9324
US

V. Phone/Fax

Practice location:
  • Phone: 304-644-6620
  • Fax:
Mailing address:
  • Phone: 304-644-6620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number31200
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3093
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: