Provider Demographics
NPI:1679745749
Name:HAYS, LISA KAY (RN LMFT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:KAY
Last Name:HAYS
Suffix:
Gender:F
Credentials:RN LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 RIVERGATE
Mailing Address - Street 2:B-1 #224
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-7470
Mailing Address - Country:US
Mailing Address - Phone:970-769-0053
Mailing Address - Fax:
Practice Address - Street 1:2223 MAIN AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-4654
Practice Address - Country:US
Practice Address - Phone:970-769-0053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-29
Last Update Date:2008-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO723106H00000X
CO150924163WC1600X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health