Provider Demographics
NPI:1033915319
Name:HEALY, HALEY (LSW)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:HEALY
Suffix:
Gender:
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 WICHMAN LN
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-5532
Mailing Address - Country:US
Mailing Address - Phone:317-318-4188
Mailing Address - Fax:
Practice Address - Street 1:1503 WICHMAN LN
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-5532
Practice Address - Country:US
Practice Address - Phone:317-318-4188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33012803A104100000X
CT10004104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker