Provider Demographics
NPI:1053993253
Name:ALSAFFAR, HALEY (MS, NCC, LPC-MHSP)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:ALSAFFAR
Suffix:
Gender:F
Credentials:MS, NCC, LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 383
Mailing Address - Street 2:
Mailing Address - City:ELLENDALE
Mailing Address - State:TN
Mailing Address - Zip Code:38029-0383
Mailing Address - Country:US
Mailing Address - Phone:901-877-4118
Mailing Address - Fax:
Practice Address - Street 1:2000 N PARKWAY
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-1624
Practice Address - Country:US
Practice Address - Phone:901-877-4118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-27
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3396101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health