Provider Demographics
NPI:1699167247
Name:HAIES, DAVID (LCSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:HAIES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:HAIES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:150 COLERIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4131
Mailing Address - Country:US
Mailing Address - Phone:718-313-2840
Mailing Address - Fax:718-759-4197
Practice Address - Street 1:150 COLERIDGE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4131
Practice Address - Country:US
Practice Address - Phone:718-313-2840
Practice Address - Fax:718-759-4197
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-19
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0827301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical