Provider Demographics
NPI:1225810690
Name:RICHARD, HALEY (MS, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:RICHARD
Suffix:
Gender:F
Credentials:MS, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 PAIGE HILL RD
Mailing Address - Street 2:
Mailing Address - City:BRIMFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01010-9779
Mailing Address - Country:US
Mailing Address - Phone:413-241-1160
Mailing Address - Fax:
Practice Address - Street 1:157 PAIGE HILL RD
Practice Address - Street 2:
Practice Address - City:BRIMFIELD
Practice Address - State:MA
Practice Address - Zip Code:01010-9779
Practice Address - Country:US
Practice Address - Phone:413-343-4175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-19
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2372168363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health