JAMIE RENEE HAIRSTON MS, LASAC
NPI 1790387603
Counselor - Addiction (Substance Use Disorder) in Kingman, AZ
Active since November 15, 2020
About Jamie Renee Hairston Ms, Lasac NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JAMIE RENEE HAIRSTON MS, LASAC (NPI 1790387603) is an individual addiction (substance use disorder) provider in Kingman, Arizona, licensed in Arizona (15285) and active in the NPI registry since November 2020.
NPPES Registry Identity
NPI1790387603
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameJAMIE RENEE HAIRSTONCredential: MS, LASAC
Location Address3240 HUALAPAI MOUNTAIN RDKingman, AZ 86401-5306
Mailing Address3609 N Arizona StKingman, AZ 86409-0749 · (520) 561-7078
Phone(928) 753-2665
Sole ProprietorNo
Enumeration DateNovember 15, 2020
NPPES CertifiedNovember 15, 2020
✔ NPI 1790387603 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in AZ · 15285
3240 HUALAPAI MOUNTAIN RD, Kingman, AZ 86401
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790387603, enumerated as an "individual" on November 15, 2020.
The provider is located at 3240 HUALAPAI MOUNTAIN RD KINGMAN, AZ 86401 and the phone number is (928) 753-2665.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
