Provider Demographics
NPI:1710455399
Name:HALEY, CHRISTINE DANIELLE (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:DANIELLE
Last Name:HALEY
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 1:5889 FORBES AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-4604
Mailing Address - Country:US
Mailing Address - Phone:412-935-0359
Mailing Address - Fax:
Practice Address - Street 1:5889 FORBES AVE STE 210
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-4604
Practice Address - Country:US
Practice Address - Phone:412-935-0359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-13
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010890101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001517224002Medicaid