Provider Demographics
NPI:1659440840
Name:HALEY, MARY THERESA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:THERESA
Last Name:HALEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2644 S TROY CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3392
Mailing Address - Country:US
Mailing Address - Phone:303-886-5560
Mailing Address - Fax:
Practice Address - Street 1:2644 S TROY CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3392
Practice Address - Country:US
Practice Address - Phone:130-388-6556
Practice Address - Fax:303-886-5560
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.0009926301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical