Provider Demographics
NPI:1841794559
Name:ORENDOFF, HAYLEY JAYNE (LCSW)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:JAYNE
Last Name:ORENDOFF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:J
Other - Last Name:HENSGEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1118 N DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:CARTERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62918-3269
Mailing Address - Country:US
Mailing Address - Phone:618-967-1418
Mailing Address - Fax:
Practice Address - Street 1:2401 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-1188
Practice Address - Country:US
Practice Address - Phone:618-997-5311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0184511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical