Provider Demographics
NPI:1093425738
Name:ZOLLER, HALEY ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:ANN
Last Name:ZOLLER
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 1:66A SHARON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-2604
Mailing Address - Country:US
Mailing Address - Phone:508-523-9173
Mailing Address - Fax:
Practice Address - Street 1:66A SHARON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-2604
Practice Address - Country:US
Practice Address - Phone:508-523-9173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY093520-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical