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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