Provider Demographics
NPI:1235427790
Name:HALEY-FRANKLIN, HEIDI LEE (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:LEE
Last Name:HALEY-FRANKLIN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 CENTRAL AVE E
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAINT MICHAEL
Mailing Address - State:MN
Mailing Address - Zip Code:55376-9511
Mailing Address - Country:US
Mailing Address - Phone:763-515-4563
Mailing Address - Fax:763-497-0552
Practice Address - Street 1:112 CENTRAL AVE E
Practice Address - Street 2:SUITE A
Practice Address - City:SAINT MICHAEL
Practice Address - State:MN
Practice Address - Zip Code:55376-9511
Practice Address - Country:US
Practice Address - Phone:763-515-4563
Practice Address - Fax:763-497-0552
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN181081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical