Provider Demographics
NPI:1841945151
Name:WILLIAMS, HAYLEY ALYSSA (PROVISIONAL LMSW)
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:ALYSSA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PROVISIONAL LMSW
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:ALYSSA
Other - Last Name:SHARPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12452 S NORWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-9002
Mailing Address - Country:US
Mailing Address - Phone:918-284-1244
Mailing Address - Fax:
Practice Address - Street 1:1516 S BOSTON AVE STE 1
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-4029
Practice Address - Country:US
Practice Address - Phone:918-561-6001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8036-P101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health