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General NPI Number Information
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NPI Number | 1477170801
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Entity Type | Individual
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Provider Name | HAILEY ELEEN WILSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/01/2020
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 1315 JAMESTOWN RD STE 104
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-3363
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Country | US
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Telephone | 757-788-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 2808 MOREELL AVE
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City | SOUTH PRINCE GEORGE
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State | VA
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Zip | 23805-7729
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0906013226
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License Number State | VA
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