Healthcare Provider Details

I. General information

NPI: 1437728334
Provider Name (Legal Business Name): HAYLEY ELIZABETH PETERSON MA, LPC, NCC, BCTMH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HAYLEY ELIZABETH PETERSON HAYLEY ELIZABETH FOX

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 06/23/2021
Certification Date: 05/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1056 CORPORATE LN
EXPORT PA
15632-8905
US

IV. Provider business mailing address

1056 CORPORATE LN
EXPORT PA
15632-8905
US

V. Phone/Fax

Practice location:
  • Phone: 412-639-9570
  • Fax:
Mailing address:
  • Phone: 412-639-9570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC013410
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: