Provider Demographics
NPI:1962895318
Name:HALEY, ANDRE (PHD, LCDP, LMSW)
Entity type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:
Last Name:HALEY
Suffix:
Gender:M
Credentials:PHD, LCDP, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3113 N VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-2939
Mailing Address - Country:US
Mailing Address - Phone:302-563-8399
Mailing Address - Fax:
Practice Address - Street 1:19 LAMBSON LN # B-102
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-2118
Practice Address - Country:US
Practice Address - Phone:302-337-5513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-10
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECD-0000100101YA0400X
PABH004301103K00000X
DE1460101YA0400X
DEQ3-0000164104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst