Healthcare Provider Details

I. General information

NPI: 1457028813
Provider Name (Legal Business Name): HAYLEY RENEE MINGER-MARLOW M.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HAYLEY RENEE MARLOW LMSW

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 12/21/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23100 JEFFERSON AVE
SAINT CLAIR SHORES MI
48080-2756
US

IV. Provider business mailing address

20013 BLACKBURN ST
SAINT CLAIR SHORES MI
48080-1051
US

V. Phone/Fax

Practice location:
  • Phone: 586-335-2006
  • Fax: 586-279-3886
Mailing address:
  • Phone: 313-418-8928
  • Fax: 586-279-3886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: