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General NPI Number Information
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NPI Number | 1154051985
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Entity Type | Individual
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Provider Name | MISS JUSTICE HAYZE
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Gender | Female
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 7400 W CAMPUS RD # 43054
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City | NEW ALBANY
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State | OH
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Zip | 43054-8722
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Country | US
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Telephone | 937-284-1391
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Fax |
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Provider Business Mailing Address
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Address Line | 366 GILBERT AVE
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City | FAIRBORN
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State | OH
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Zip | 45324-3208
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Country | US
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Telephone | 404-234-9141
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDCA.185451
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | CDCA.185451
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | YPS.000023
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | APS.002598
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License Number State | OH
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