Provider Demographics
NPI:1477914844
Name:HAYLEY NEMETH, LCSW, PLLC
Entity Type:Organization
Organization Name:HAYLEY NEMETH, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:HAYLEY
Authorized Official - Middle Name:ALISE
Authorized Official - Last Name:NEMETH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:410-490-5137
Mailing Address - Street 1:3814 HABBERLINE ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-7212
Mailing Address - Country:US
Mailing Address - Phone:410-490-5137
Mailing Address - Fax:
Practice Address - Street 1:3814 HABBERLINE ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-7212
Practice Address - Country:US
Practice Address - Phone:410-490-5137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC007841251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1548523640Medicaid