Provider Demographics
NPI:1568001618
Name:BUCK, HALEY PAYNE (LPCC)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:PAYNE
Last Name:BUCK
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:
Other - Last Name:PAYNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:KUTTAWA
Mailing Address - State:KY
Mailing Address - Zip Code:42055-0250
Mailing Address - Country:US
Mailing Address - Phone:270-601-4235
Mailing Address - Fax:270-963-3038
Practice Address - Street 1:68 CEDAR ST
Practice Address - Street 2:
Practice Address - City:KUTTAWA
Practice Address - State:KY
Practice Address - Zip Code:42055-6287
Practice Address - Country:US
Practice Address - Phone:270-601-4235
Practice Address - Fax:270-963-3038
Is Sole Proprietor?:No
Enumeration Date:2020-01-06
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY261049101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor