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Organization
ID SUBSTRATE, PLLC
Active
Organization
ID SUBSTRATE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FLYN HAYES MS FOR PSY LISAC (HEALTH CARE PROVIDER)
(602) 405-4622
Entity
Organization
Contact information
Practice address
4500 N. 32ND STREET, 100-A, PHOENIX, AZ 85018-3033
(602) 200-8690
(602) 264-8107
Mailing address
PO BOX 10044, PHOENIX, AZ 85064-0044
(602) 405-4622
(602) 264-8107
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
103TF0200X
Forensic Psychologist
—
NULL
103TF0200X
Forensic Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
NULL
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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