MEDICARE: HALEY KAY HEPLER MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	S.2001266-TRNE	OH
2	1041C0700X	Clinical Social Worker	CSW.09930204	CO

General Provider Information

NPI Number	:	1023620044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEY KAY HEPLER MSW, LCSW

Provider Business Mailing Address
First Line	:	1090 S WADSWORTH BLVD
Second Line	:	UNIT C PMB 5005
City	:	LAKEWOOD
State	:	CO
Zip	:	80226
Country	:	US
Telephone Number	:	330-280-4191
Fax Number	:

Provider Business Practice Location Address
First Line	:	1090 S WADSWORTH BLVD
Second Line	:	UNIT C PMB 5005
City	:	LAKEWOOD
State	:	CO
Zip	:	80226
Country	:	US
Telephone Number	:	330-280-4191
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2020
Last Update Date	:	03/06/2024

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