Provider Demographics
NPI:1336405786
Name:HAYSBERT, NINEVEH
Entity type:Individual
Prefix:MS
First Name:NINEVEH
Middle Name:
Last Name:HAYSBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:NINEVEH
Other - Middle Name:
Other - Last Name:HAYSBERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CWIC, LPC, LADC,DCC
Mailing Address - Street 1:PO BOX 3622
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23663-0622
Mailing Address - Country:US
Mailing Address - Phone:757-310-8178
Mailing Address - Fax:
Practice Address - Street 1:422 MADISON AVE
Practice Address - Street 2:
Practice Address - City:KINGSTREE
Practice Address - State:SC
Practice Address - Zip Code:29556-3619
Practice Address - Country:US
Practice Address - Phone:757-310-8178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional