Provider Demographics
NPI:1104416494
Name:RAY, HALEY (LICSW)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:RAY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:
Other - Last Name:WILKEMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:1113 PINE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54022-8300
Mailing Address - Country:US
Mailing Address - Phone:507-459-8144
Mailing Address - Fax:
Practice Address - Street 1:1 VETERANS DR
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-2309
Practice Address - Country:US
Practice Address - Phone:612-725-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical