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General NPI Number Information
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NPI Number | 1215168281
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Entity Type | Organization
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Legal Business Name | HALEY COUNSELING CENTER
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Dates
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Enumeration Date | 08/07/2009
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Last Update Date | 08/07/2009
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Provider Practice Location Address
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Address Line | 17 MAIN ST
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City | HEBRON
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State | CT
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Zip | 06248-1514
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Country | US
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Telephone | 860-206-6709
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Fax |
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Provider Business Mailing Address
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Address Line | 17 MAIN STREET
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City | HEBRON
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State | CT
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Zip | 06248
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Country | US
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Telephone | 860-206-6709
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. STEPHEN M HALEY
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Credential | LCSW
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Telephone | 860-228-6866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 03572882
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License Number State | CT
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