Provider Demographics
NPI:1285781567
Name:HALLEY, STEVEN MS (LSCSW)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:MS
Last Name:HALLEY
Suffix:
Gender:M
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 225
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:KS
Mailing Address - Zip Code:66743-0225
Mailing Address - Country:US
Mailing Address - Phone:620-724-7111
Mailing Address - Fax:620-724-7168
Practice Address - Street 1:108 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:KS
Practice Address - Zip Code:66743-1337
Practice Address - Country:US
Practice Address - Phone:620-724-7111
Practice Address - Fax:620-724-7168
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1912101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100387630AMedicaid
KS100387630AMedicaid