Provider Demographics
NPI:1104840214
Name:HALEY, BETHANY (LCSW)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:HALEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 25TH AVE N
Mailing Address - Street 2:SUITE 309
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1515
Mailing Address - Country:US
Mailing Address - Phone:615-424-5440
Mailing Address - Fax:
Practice Address - Street 1:310 25TH AVE N
Practice Address - Street 2:SUITE 309
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1515
Practice Address - Country:US
Practice Address - Phone:615-424-5440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical