Provider Demographics
NPI:1437806056
Name:ZEIEN, HALEY (LSW)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:ZEIEN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:313 N MATTIS AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61821-7900
Mailing Address - Country:US
Mailing Address - Phone:217-203-2008
Mailing Address - Fax:
Practice Address - Street 1:313 N MATTIS AVE STE 116
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61821-7900
Practice Address - Country:US
Practice Address - Phone:217-203-2008
Practice Address - Fax:844-412-7089
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.106884104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker