Provider Demographics
NPI:1043880289
Name:HARRIS, HAILEY COLE (LPC)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:COLE
Last Name:HARRIS
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 1:1853 S KAMIAH LN
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-5015
Mailing Address - Country:US
Mailing Address - Phone:928-814-3162
Mailing Address - Fax:
Practice Address - Street 1:2971 E COPPER POINT DR
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-5101
Practice Address - Country:US
Practice Address - Phone:208-376-5683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID8244101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional