1447558531 NPI number — MISS RACQUEL VALENCIA HAYS LCSW

Table of content: MISS RACQUEL VALENCIA HAYS LCSW (NPI 1447558531)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447558531 NPI number — MISS RACQUEL VALENCIA HAYS LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAYS
Provider First Name:
RACQUEL
Provider Middle Name:
VALENCIA
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447558531
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/12/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5710 W GUNNISON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60630-3218
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-912-8534
Provider Business Mailing Address Fax Number:
847-779-9519

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 W CENTRAL RD
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
MOUNT PROSPECT
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60056-2347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-912-8534
Provider Business Practice Location Address Fax Number:
847-779-9519
Provider Enumeration Date:
03/14/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  149008221 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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