Provider Demographics
NPI:1912731977
Name:WHITEHEAD, HALEY
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:WHITEHEAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 VADNAIS ST
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-3026
Mailing Address - Country:US
Mailing Address - Phone:413-388-8093
Mailing Address - Fax:
Practice Address - Street 1:395 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3779
Practice Address - Country:US
Practice Address - Phone:413-272-1333
Practice Address - Fax:413-858-2618
Is Sole Proprietor?:No
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor