Provider Demographics
NPI:1417071580
Name:HAYLEY, MARY HUNT (LCSW, PHD)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:HUNT
Last Name:HAYLEY
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 UNIVERSITY PL STE 205
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4575
Mailing Address - Country:US
Mailing Address - Phone:212-206-0449
Mailing Address - Fax:
Practice Address - Street 1:99 UNIVERSITY PL STE 205
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4575
Practice Address - Country:US
Practice Address - Phone:212-206-0449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0601271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02147157Medicaid
NYNE7731Medicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER