Provider Demographics
NPI:1497094833
Name:BRYANT, HALEY (LPC, LAMFT)
Entity Type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:LPC, LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956-4300
Mailing Address - Country:US
Mailing Address - Phone:479-414-3865
Mailing Address - Fax:479-777-8510
Practice Address - Street 1:1403 HIDDEN VALLEY ST
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956-2125
Practice Address - Country:US
Practice Address - Phone:479-414-3865
Practice Address - Fax:479-777-8510
Is Sole Proprietor?:No
Enumeration Date:2013-02-05
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA1302009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR177755526Medicaid