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General NPI Number Information
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NPI Number | 1992303002
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Entity Type | Individual
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Provider Name | HALEY RENAE RUST LCMFT
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Gender | Female
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Dates
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Enumeration Date | 10/12/2020
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 1938 N WOODLAWN ST STE 400
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City | WICHITA
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State | KS
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Zip | 67208-1875
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Country | US
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Telephone | 316-660-9600
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Fax |
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Provider Business Mailing Address
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Address Line | 15440 W 65TH ST
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City | SHAWNEE
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State | KS
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Zip | 66217-9306
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Country | US
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Telephone | 316-789-5327
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 03190-T
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 03405
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License Number State | KS
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