Provider Demographics
NPI:1548523640
Name:NEMETH, HAYLEY ALISE (LCSW)
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:ALISE
Last Name:NEMETH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 N 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-3424
Mailing Address - Country:US
Mailing Address - Phone:410-490-5137
Mailing Address - Fax:
Practice Address - Street 1:4000 SHIPYARD BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6192
Practice Address - Country:US
Practice Address - Phone:910-392-4881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0078411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical