Provider Demographics
NPI:1407885395
Name:HALEY, SARAH J (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:J
Last Name:HALEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7021 KEWANEE AVE
Mailing Address - Street 2:UNIT 2104
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-7049
Mailing Address - Country:US
Mailing Address - Phone:806-687-9414
Mailing Address - Fax:806-687-9415
Practice Address - Street 1:7021 KEWANEE AVE
Practice Address - Street 2:UNIT 2104
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-7049
Practice Address - Country:US
Practice Address - Phone:806-687-9414
Practice Address - Fax:806-687-9415
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3-2013103TC0700X
TX32013103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86757AOtherBLUE CROSS BLUE SHIELD
TX154470201Medicaid
TX154470201Medicaid