Provider Demographics
NPI:1790988897
Name:HALEY, SEAN S (MS, NCC, PLMHP)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:S
Last Name:HALEY
Suffix:
Gender:M
Credentials:MS, NCC, PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11414 W CENTER RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-4486
Mailing Address - Country:US
Mailing Address - Phone:402-330-4014
Mailing Address - Fax:402-334-2930
Practice Address - Street 1:11414 W CENTER RD
Practice Address - Street 2:SUITE 220
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-4486
Practice Address - Country:US
Practice Address - Phone:402-330-4014
Practice Address - Fax:402-334-2930
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8335101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE8335OtherPLMHP