MEDICARE: CHRISTA NICOLE HANEY MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	3093	WV

General Provider Information

NPI Number	:	1770272080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTA NICOLE HANEY MS

Provider Business Mailing Address
First Line	:	35 EDGEWOOD HILLS RD
Second Line	:
City	:	OAK HILL
State	:	WV
Zip	:	25901-9324
Country	:	US
Telephone Number	:	304-644-6620
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 EDGEWOOD HILLS RD
Second Line	:
City	:	OAK HILL
State	:	WV
Zip	:	25901-9324
Country	:	US
Telephone Number	:	304-644-6620
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2023
Last Update Date	:	01/20/2026

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