Provider Demographics
NPI:1649236878
Name:HAIGLEY, STEPHEN SCOTT (LCPC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:SCOTT
Last Name:HAIGLEY
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 DOWNING RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-4114
Mailing Address - Country:US
Mailing Address - Phone:410-262-1146
Mailing Address - Fax:410-741-3817
Practice Address - Street 1:3000 CHESTNUT AVE
Practice Address - Street 2:THE MILL CENTRE, SUITE 204
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-2727
Practice Address - Country:US
Practice Address - Phone:410-262-1146
Practice Address - Fax:410-741-3817
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK333101YP2500X
MDLC1125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional