Provider Demographics
NPI:1962969667
Name:WALKER, HALEY ELIZABETH (LPC)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:ELIZABETH
Last Name:WALKER
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25491 AUDRAIN ROAD 824
Mailing Address - Street 2:
Mailing Address - City:MEXICO
Mailing Address - State:MO
Mailing Address - Zip Code:65265-6708
Mailing Address - Country:US
Mailing Address - Phone:573-721-5506
Mailing Address - Fax:
Practice Address - Street 1:210 E LOVE ST
Practice Address - Street 2:
Practice Address - City:MEXICO
Practice Address - State:MO
Practice Address - Zip Code:65265-2880
Practice Address - Country:US
Practice Address - Phone:573-721-5506
Practice Address - Fax:888-460-8878
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-28
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019006432101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional