Healthcare Provider Details

I. General information

NPI: 1760262182
Provider Name (Legal Business Name): HALEY ANTHONY COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2023
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 PLEASANT HOME RD
AUGUSTA GA
30907-0518
US

IV. Provider business mailing address

272 WALNUT LN
NORTH AUGUSTA SC
29860-9215
US

V. Phone/Fax

Practice location:
  • Phone: 706-364-4599
  • Fax: 706-364-4589
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: HALEY ANTHONY
Title or Position: PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 803-645-4630