Provider Demographics
NPI:1285209460
Name:HAYES, CHRISTINA (LMSW)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:HAYES
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6070 NEWPORT RD
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49002-9234
Mailing Address - Country:US
Mailing Address - Phone:269-547-6877
Mailing Address - Fax:
Practice Address - Street 1:5380 HOLIDAY TER STE 28
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-2128
Practice Address - Country:US
Practice Address - Phone:269-303-3289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-21
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011152161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical