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NPI Code Detail

MEDICARE: MR. MICHAEL JON HALEY LCSW

MEDICARE:  MR. MICHAEL JON HALEY  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
21041C0700XClinical Social Worker

General Provider Information

NPI Number : 1912041237
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL JON HALEY LCSW
Provider Business Mailing Address
First Line : 4856 INNOVATION DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-5539
Country : US
Telephone Number : 970-494-4200
Fax Number :
Provider Business Practice Location Address
First Line : 1250 N WILSON AVE
Second Line :
City : LOVELAND
State : CO
Zip : 80537-4461
Country : US
Telephone Number : 970-494-4200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2007
Last Update Date : 12/18/2019

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Directions to “ MR. MICHAEL JON HALEY LCSW” Practice Location

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