Provider Demographics
NPI:1013895739
Name:MANGO, HALEY LYNN (MSW, LCSWA)
Entity type:Individual
Prefix:MS
First Name:HALEY
Middle Name:LYNN
Last Name:MANGO
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1172 KINGSMILL CT
Mailing Address - Street 2:
Mailing Address - City:SUNSET BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28468-4480
Mailing Address - Country:US
Mailing Address - Phone:631-624-0744
Mailing Address - Fax:
Practice Address - Street 1:5040 NEW CENTRE DR STE D
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-1737
Practice Address - Country:US
Practice Address - Phone:910-392-4881
Practice Address - Fax:910-392-9559
Is Sole Proprietor?:No
Enumeration Date:2025-08-21
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0216331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical