Provider Demographics
NPI:1134618895
Name:HALLETT, NATHANIEL CHARLES (LCSW)
Entity type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:CHARLES
Last Name:HALLETT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2829 WEHRLE DR STE 13
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7387
Mailing Address - Country:US
Mailing Address - Phone:716-217-9278
Mailing Address - Fax:716-360-9786
Practice Address - Street 1:2829 WEHRLE DR STE 13
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7387
Practice Address - Country:US
Practice Address - Phone:716-217-9278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0933641041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical