Individual provider Active NPI

Haley Bryant, LPC, LAMFT

  • Mental Health Counselor
  • Van Buren, AR
National Provider Identifier
1497094833
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A1302009 Issued in AR
Practice address
1403 Hidden Valley St
Van Buren, AR 72956-2125
Phone
(479) 414-3865
Fax
(479) 777-8510
NPI assigned
Feb 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A1302009 AR Primary

Addresses

Primary practice location

1403 Hidden Valley St
Van Buren, AR 72956-2125

Mailing address

927 Main St Ste B
Van Buren, AR 72956-4300
Phone (479) 414-3865

Other identifiers 1

IdentifierTypeStateIssuer
177755526MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A1302009ARMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Clinic at the Forging Place Current Accepting new patients
Van Buren Counseling Inc Mental Health Current Accepting new patients
The Forging Place Mental Health Past Accepting new patients

Locations

1500 Main St
Van Buren, AR 72956
Phone (479) 719-4117

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1497094833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 MAIN ST STE B",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729564300",
            "telephone_number": "479-414-3865",
            "fax_number": "479-777-8510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 HIDDEN VALLEY ST",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729562125",
            "telephone_number": "479-414-3865",
            "fax_number": "479-777-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "HALEY",
        "name_prefix": "Mrs.",
        "credential": "LPC, LAMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-05",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A1302009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177755526",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Buren, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.