Provider Demographics
NPI:1134460306
Name:DR HALEY'S SOCIAL SKILLS CENTER
Entity Type:Organization
Organization Name:DR HALEY'S SOCIAL SKILLS CENTER
Other - Org Name:THE SOCIAL SKILLS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HALEY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:571-285-1403
Mailing Address - Street 1:13885 HEDGEWOOD DR STE 233
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-7931
Mailing Address - Country:US
Mailing Address - Phone:571-285-1403
Mailing Address - Fax:703-490-4525
Practice Address - Street 1:13885 HEDGEWOOD DR STE 233
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-7931
Practice Address - Country:US
Practice Address - Phone:571-285-1403
Practice Address - Fax:703-490-4525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002757103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty