Provider Demographics
NPI:1346916921
Name:MICHNO, HALEY (LMSW)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:MICHNO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 E 27TH ST APT 24K
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9259
Mailing Address - Country:US
Mailing Address - Phone:203-918-0515
Mailing Address - Fax:
Practice Address - Street 1:156 5TH AVE STE 1118
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7744
Practice Address - Country:US
Practice Address - Phone:917-510-4217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY110833-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker