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Provider Information for 1245428242



MS. HALEE FAWNE ROBERTS LCSW

Gender: FEMALE

Individual NPI: 1245428242

Calendar Last Updated: 2016-03-14

Details

Name Value
NPI 1245428242
Enumeration Date 2007-10-04
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 2400 S 48TH ST
SPRINGDALE, AR 72762-6683
United States

Phone: 479-750-2020 | Fax: 479-750-4843
View Map External Link
Primary Practice Address 2400 S 48TH ST
SPRINGDALE, AR 72762-6683
United States

Phone: 479-750-2020 | Fax: 479-750-4843
View Map External Link
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1041C0700X - Social Worker Clinical AR 2168-C
Other Identifiers
Issuer State Number
Other BCBS 5A580
Other CORPHEALTH 710401764
Other USABLE 5A580
MEDICAID AR 116399726
Other MHN 1245428242
Other HEALTH ADV 5A580
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location