Provider Demographics
NPI:1588204770
Name:WILDS, HAYLEY ERIN (LPC)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:ERIN
Last Name:WILDS
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 1:5831 FORWARD AVE # 1022
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2301
Mailing Address - Country:US
Mailing Address - Phone:412-501-3880
Mailing Address - Fax:
Practice Address - Street 1:5831 FORWARD AVE # 1022
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2301
Practice Address - Country:US
Practice Address - Phone:412-501-3880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-15
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008173101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC008173OtherDEPARTMENT OF STATE