Provider Demographics
NPI:1285288548
Name:PARKER, HALEY (MA)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 MORNINGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HARRISONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64701-3969
Mailing Address - Country:US
Mailing Address - Phone:816-289-3174
Mailing Address - Fax:
Practice Address - Street 1:1004 S CLAIRBORNE RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-2138
Practice Address - Country:US
Practice Address - Phone:913-617-0492
Practice Address - Fax:913-300-9675
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
1-21-54528103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
RBT-19-88197OtherPRIVATE INSURANCE
1-21-54528OtherBACB