MEDICARE: HAYLEY RENEE MALOY 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	1041C0700X	Clinical Social Worker	SW26278	FL
2	1041C0700X	Clinical Social Worker	LCSW-23665	AZ

General Provider Information

NPI Number	:	1205442548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAYLEY RENEE MALOY LCSW

Provider Business Mailing Address
First Line	:	2033 E EDGEWOOD DR STE 4
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33803-3660
Country	:	US
Telephone Number	:	863-797-4040
Fax Number	:

Provider Business Practice Location Address
First Line	:	2033 E EDGEWOOD DR STE 4
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33803-3660
Country	:	US
Telephone Number	:	863-797-4040
Fax Number	:

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

Provider Enumeration Date	:	09/22/2020
Last Update Date	:	04/20/2026

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