Provider Demographics
NPI:1033710900
Name:MCDEVITT, HAILEY (LPC)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:
Last Name:MCDEVITT
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 1:1819 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-3956
Mailing Address - Country:US
Mailing Address - Phone:208-429-3854
Mailing Address - Fax:208-336-7290
Practice Address - Street 1:1819 W STATE ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-3956
Practice Address - Country:US
Practice Address - Phone:208-429-3854
Practice Address - Fax:208-336-7290
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID5141101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health