Healthcare Provider Details

I. General information

NPI: 1851238331
Provider Name (Legal Business Name): HAYLEY CHARLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2942 E BATTLEFIELD RD
SPRINGFIELD MO
65804-4016
US

IV. Provider business mailing address

1905 S VENTURA AVE
SPRINGFIELD MO
65804-2713
US

V. Phone/Fax

Practice location:
  • Phone: 417-929-5770
  • Fax:
Mailing address:
  • Phone: 785-650-9551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2025033631
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: