Provider Demographics
NPI:1013193432
Name:KAST, HAYLEY ELIZABETH (LPC)
Entity Type:Individual
Prefix:DR
First Name:HAYLEY
Middle Name:ELIZABETH
Last Name:KAST
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 KILGORE RD STE 206
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30116-1899
Mailing Address - Country:US
Mailing Address - Phone:770-653-5974
Mailing Address - Fax:
Practice Address - Street 1:173 KILGORE RD STE 206
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30116-1899
Practice Address - Country:US
Practice Address - Phone:770-653-5974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004967101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional