=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528931672
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HAILEY ELIZABETH ALLES LSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/25/2025
-----------------------------------------------------
Last Update Date | 10/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19 E MAIN ST
-----------------------------------------------------
City | MARLTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08053-2172
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-985-9091
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 198 FAIRFAX DR
-----------------------------------------------------
City | CINNAMINSON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08077-2133
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-345-9411
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 44SL07366300
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------