Provider Demographics
NPI:1477270460
Name:KELLEY, HALEIGH JOYCE WALCOTT (LPC)
Entity Type:Individual
Prefix:
First Name:HALEIGH
Middle Name:JOYCE WALCOTT
Last Name:KELLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5028 KINGS GRANT CIR
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-7295
Mailing Address - Country:US
Mailing Address - Phone:540-435-3637
Mailing Address - Fax:
Practice Address - Street 1:5028 KINGS GRANT CIR
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-7295
Practice Address - Country:US
Practice Address - Phone:540-435-3637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2024-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701011903101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health