Provider Demographics
NPI:1578644134
Name:HALYARD, PEGGY E (MS, LPC)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:E
Last Name:HALYARD
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 NORTH LOOP W STE 220
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1082
Mailing Address - Country:US
Mailing Address - Phone:713-426-1669
Mailing Address - Fax:713-868-9416
Practice Address - Street 1:560 BLOSSOM ST STE B
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4237
Practice Address - Country:US
Practice Address - Phone:281-338-1382
Practice Address - Fax:281-488-3841
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14706101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3675LCOtherBCBS/TX