Provider Demographics
NPI:1609555671
Name:ANTHONY, HALEY (LPC)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:ANTHONY
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 1:272 WALNUT LN
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29860-9215
Mailing Address - Country:US
Mailing Address - Phone:803-645-4630
Mailing Address - Fax:
Practice Address - Street 1:211 PLEASANT HOME RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-0518
Practice Address - Country:US
Practice Address - Phone:706-364-4599
Practice Address - Fax:706-364-4589
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC014034101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional