Provider Demographics
NPI:1922499425
Name:HALESWORTH, STEPHANIE MORGAN (LMHC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MORGAN
Last Name:HALESWORTH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:MORGAN
Other - Last Name:COHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:260 MADISON AVE FL 8
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2418
Mailing Address - Country:US
Mailing Address - Phone:917-860-4672
Mailing Address - Fax:
Practice Address - Street 1:260 MADISON AVE FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2418
Practice Address - Country:US
Practice Address - Phone:917-860-4672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006912101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health