Provider Demographics
NPI:1083850143
Name:TERRELL, HALLEY CEGLIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HALLEY
Middle Name:CEGLIA
Last Name:TERRELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:HALLEY
Other - Middle Name:G
Other - Last Name:CEGLIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:230 SEASIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06605-3530
Mailing Address - Country:US
Mailing Address - Phone:516-578-2560
Mailing Address - Fax:
Practice Address - Street 1:230 SEASIDE AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06605-3530
Practice Address - Country:US
Practice Address - Phone:516-578-2560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0755251041C0700X
CT0076421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical