Healthcare Provider Details

I. General information

NPI: 1053607366
Provider Name (Legal Business Name): HALEY YARBROUGH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2011
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 HWY 65 NORTH
MARSHALL AR
72650
US

IV. Provider business mailing address

2400 S 48TH ST
SPRINGDALE AR
72762-6683
US

V. Phone/Fax

Practice location:
  • Phone: 870-448-4727
  • Fax: 870-448-4496
Mailing address:
  • Phone: 479-725-5115
  • Fax: 479-750-4843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number10097M
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10097-C
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: