Provider Demographics
NPI:1215035183
Name:HALEY, CHRISTOPHER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:HALEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13885 HEDGEWOOD DRIVE
Mailing Address - Street 2:SUITE 245
Mailing Address - City:WOODRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193
Mailing Address - Country:US
Mailing Address - Phone:703-490-0336
Mailing Address - Fax:703-490-4525
Practice Address - Street 1:13885 HEDGEWOOD DRIVE
Practice Address - Street 2:SUITE 245
Practice Address - City:WOODRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193
Practice Address - Country:US
Practice Address - Phone:703-490-0336
Practice Address - Fax:703-490-4525
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002757103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
030389866OtherTRICARE
VA218354OtherKAISER PERMANENTE
VA23570010OtherCAREFIRST
VA275693OtherANTHEM