Provider Demographics
NPI:1063305761
Name:NAIL, HALEY NICCOLE (LCSW)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:NICCOLE
Last Name:NAIL
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 1:2911 CABANA LN APT 109
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-7862
Mailing Address - Country:US
Mailing Address - Phone:321-222-0902
Mailing Address - Fax:321-541-9135
Practice Address - Street 1:1211 ADMIRALTY BLVD
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-5201
Practice Address - Country:US
Practice Address - Phone:321-258-9537
Practice Address - Fax:321-541-9135
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-31
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW248321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical