Provider Demographics
NPI:1831582956
Name:BLOUNT, HAILEY (LCSW)
Entity type:Individual
Prefix:
First Name:HAILEY
Middle Name:
Last Name:BLOUNT
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:HAILEY
Other - Middle Name:
Other - Last Name:VIEIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:4140 OCEANSIDE BLVD STE 159
Mailing Address - Street 2:#221
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-6005
Mailing Address - Country:US
Mailing Address - Phone:805-816-8005
Mailing Address - Fax:
Practice Address - Street 1:1075 CAMINO DEL RIO S
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3538
Practice Address - Country:US
Practice Address - Phone:619-881-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-13
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 171M00000X
CA84314104100000X
CA1005821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator