Provider Demographics
NPI:1902377096
Name:HAYLEY ALLEN-BLAKNEY, LCSW, PLLC
Entity Type:Organization
Organization Name:HAYLEY ALLEN-BLAKNEY, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OUTPATIENT THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HAYLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN-BLAKNEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-396-2267
Mailing Address - Street 1:PO BOX 451
Mailing Address - Street 2:
Mailing Address - City:THOMPSON FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59873-0451
Mailing Address - Country:US
Mailing Address - Phone:406-396-2267
Mailing Address - Fax:
Practice Address - Street 1:2504 TRADEWINDS WAY
Practice Address - Street 2:
Practice Address - City:THOMPSON FALLS
Practice Address - State:MT
Practice Address - Zip Code:59873-9707
Practice Address - Country:US
Practice Address - Phone:406-396-2267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1508299355OtherTYPE 1 NPI