Healthcare Provider Details

I. General information

NPI: 1003635764
Provider Name (Legal Business Name): BRIANNA HAYNE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRIANNA SIMPSON

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4055 MONROEVILLE BLVD
MONROEVILLE PA
15146-2522
US

IV. Provider business mailing address

1715 BROAD ST APT B
GREENSBURG PA
15601-5504
US

V. Phone/Fax

Practice location:
  • Phone: 412-414-9916
  • Fax:
Mailing address:
  • Phone: 724-972-8912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC020772
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: