Provider Demographics
NPI:1326491135
Name:BRICKER, HAYLEY (LSW)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:
Last Name:BRICKER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 E 6TH ST
Mailing Address - Street 2:UNIT 203
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-2862
Mailing Address - Country:US
Mailing Address - Phone:254-265-1281
Mailing Address - Fax:
Practice Address - Street 1:207 E 6TH ST
Practice Address - Street 2:UNIT 203
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-2862
Practice Address - Country:US
Practice Address - Phone:254-265-1281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-16
Last Update Date:2016-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS. 11011571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical