Provider Demographics
NPI:1790527117
Name:MARSHALL, HALEY (LCSW)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:
Other - Last Name:MCGOFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1200 FOX HUNT AVE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79108-4313
Mailing Address - Country:US
Mailing Address - Phone:806-231-3574
Mailing Address - Fax:
Practice Address - Street 1:1200 FOX HUNT AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79108-4313
Practice Address - Country:US
Practice Address - Phone:806-231-3574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-07
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX680551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical