Provider Demographics
NPI:1093166126
Name:ROJAS, HAILEY (MED LCSW)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:
Last Name:ROJAS
Suffix:
Gender:F
Credentials:MED LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 ALTAMA CONNECTOR
Mailing Address - Street 2:363
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-1888
Mailing Address - Country:US
Mailing Address - Phone:404-797-5586
Mailing Address - Fax:912-330-1016
Practice Address - Street 1:1610 REYNOLDS ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-6731
Practice Address - Country:US
Practice Address - Phone:404-797-5586
Practice Address - Fax:912-330-1016
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2017-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0057341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical