Provider Demographics
NPI:1750041455
Name:DEMAREE, HALEY NICHOLE (LMHC)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:NICHOLE
Last Name:DEMAREE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 FM 20 UNIT B
Mailing Address - Street 2:
Mailing Address - City:RED ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78662-2618
Mailing Address - Country:US
Mailing Address - Phone:210-995-1691
Mailing Address - Fax:
Practice Address - Street 1:2055 S PACHECO ST STE 500
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-3994
Practice Address - Country:US
Practice Address - Phone:505-209-3939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
NMCTB-2022-0706101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator