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General NPI Number Information
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NPI Number | 1780186239
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Entity Type | Individual
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Provider Name | HALEY ELIZABETH ROBERTS LICSW
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Gender | Female
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Dates
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Enumeration Date | 03/01/2018
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 309 CASE AVE SE
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City | ATTALLA
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State | AL
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Zip | 35954-3408
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Country | US
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Telephone | 256-344-3116
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 742
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City | ATTALLA
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State | AL
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Zip | 35954-0742
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Country | US
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Telephone | 256-344-3116
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 5682B
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 4682G
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 5342C
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License Number State | AL
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