Provider Demographics
NPI:1134762099
Name:MAIRE, HAILEY (LCSW)
Entity type:Individual
Prefix:
First Name:HAILEY
Middle Name:
Last Name:MAIRE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 W 1400 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-7000
Mailing Address - Country:US
Mailing Address - Phone:801-438-4045
Mailing Address - Fax:
Practice Address - Street 1:489 W 1400 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-7000
Practice Address - Country:US
Practice Address - Phone:801-438-4045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2023-08-23
Deactivation Date:2023-08-08
Deactivation Code:
Reactivation Date:2023-08-23
Provider Licenses
StateLicense IDTaxonomies
IDLCSW405861041C0700X
GACSW0082541041C0700X
WASWIA.SC.612957351041C0700X
IA1207091041C0700X
MO20220186931041C0700X
IA1207981041C0700X
KSLSCSW061781041C0700X
UT10834432-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical