Provider Demographics
NPI:1437728334
Name:PETERSON, HAYLEY ELIZABETH (MA, LPC, NCC, BCTMH)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:ELIZABETH
Last Name:PETERSON
Suffix:
Gender:F
Credentials:MA, LPC, NCC, BCTMH
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:ELIZABETH
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HAYLEY ELIZABETH FOX
Mailing Address - Street 1:1056 CORPORATE LN
Mailing Address - Street 2:
Mailing Address - City:EXPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15632-8905
Mailing Address - Country:US
Mailing Address - Phone:412-639-9570
Mailing Address - Fax:
Practice Address - Street 1:1056 CORPORATE LN
Practice Address - Street 2:
Practice Address - City:EXPORT
Practice Address - State:PA
Practice Address - Zip Code:15632-8905
Practice Address - Country:US
Practice Address - Phone:412-639-9570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013410101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional