Provider Demographics
NPI:1063891620
Name:HALEY, SONDRA (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:SONDRA
Middle Name:
Last Name:HALEY
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:SONDRA
Other - Middle Name:
Other - Last Name:HALEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC-MHSP
Mailing Address - Street 1:4610 CENTRAL AVENUE PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-4006
Mailing Address - Country:US
Mailing Address - Phone:865-243-4185
Mailing Address - Fax:
Practice Address - Street 1:6515 CLINTON HWY STE 204
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-1121
Practice Address - Country:US
Practice Address - Phone:865-243-4185
Practice Address - Fax:877-540-0353
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-28
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TN4122101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health