Healthcare Provider Details

I. General information

NPI: 1346100534
Provider Name (Legal Business Name): HALEY WILLS COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1039 WESTBROOK LN
JACKSON MO
63755-1965
US

IV. Provider business mailing address

1039 WESTBROOK LN
JACKSON MO
63755-1965
US

V. Phone/Fax

Practice location:
  • Phone: 573-275-5234
  • Fax:
Mailing address:
  • Phone: 573-275-5234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: HALEY MARIE WILLS
Title or Position: THERAPIST/OWNER
Credential: LCSW
Phone: 573-275-5234