Provider Demographics
NPI:1124555321
Name:HAYS, PHILLIP (LPC)
Entity type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:
Last Name:HAYS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 PRIVATE ROAD 3576
Mailing Address - Street 2:
Mailing Address - City:BOYD
Mailing Address - State:TX
Mailing Address - Zip Code:76023-3830
Mailing Address - Country:US
Mailing Address - Phone:817-894-1170
Mailing Address - Fax:
Practice Address - Street 1:800 US HIGHWAY 287
Practice Address - Street 2:
Practice Address - City:RHOME
Practice Address - State:TX
Practice Address - Zip Code:76078-4323
Practice Address - Country:US
Practice Address - Phone:817-894-1170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-18
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70077101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health