Healthcare Provider Details

I. General information

NPI: 1508785312
Provider Name (Legal Business Name): SAMUEL ROBERT HAFFEY LCSWA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 S MAIN ST
MARSHALL NC
28753-1007
US

IV. Provider business mailing address

152 WILLIAMS RD
FLETCHER NC
28732-8431
US

V. Phone/Fax

Practice location:
  • Phone: 828-649-9278
  • Fax:
Mailing address:
  • Phone: 828-989-2536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS-31811
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP024042
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: