Provider Demographics
NPI:1750361580
Name:DONOVAN, HAYLEE SARA (LCSW, SAP, CEAP,)
Entity type:Individual
Prefix:
First Name:HAYLEE
Middle Name:SARA
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:LCSW, SAP, CEAP,
Other - Prefix:
Other - First Name:HAYLEE
Other - Middle Name:SARA
Other - Last Name:SELTZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, SAP, CEAP
Mailing Address - Street 1:280 MADISON AVE
Mailing Address - Street 2:SUITE 1108
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-0801
Mailing Address - Country:US
Mailing Address - Phone:212-252-3769
Mailing Address - Fax:
Practice Address - Street 1:280 MADISON AVE
Practice Address - Street 2:SUITE 1108
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0801
Practice Address - Country:US
Practice Address - Phone:212-252-3769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075594-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11661377OtherCAQH