Provider Demographics
NPI:1144993965
Name:HAILEY, RHONDA CHARMAINE (MS)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:CHARMAINE
Last Name:HAILEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3390 N LUMPKIN RD APT 1108
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31903-2120
Mailing Address - Country:US
Mailing Address - Phone:267-226-5159
Mailing Address - Fax:
Practice Address - Street 1:3390 N LUMPKIN RD APT 1108
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31903-2120
Practice Address - Country:US
Practice Address - Phone:267-226-5159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171W00000X
GALPC014459101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171W00000XOther Service ProvidersContractor