Provider Demographics
NPI:1760129373
Name:HENDRICKSON, HALEY ANN (LPC)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:ANN
Last Name:HENDRICKSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:ANN
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1601 W 16TH ST
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67152-8125
Mailing Address - Country:US
Mailing Address - Phone:620-326-7448
Mailing Address - Fax:
Practice Address - Street 1:1601 W 16TH ST
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67152-8125
Practice Address - Country:US
Practice Address - Phone:620-326-7448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional