Provider Demographics
NPI:1144546938
Name:PORTEOUS-NYE, HILARY HASTINGS (LCSW)
Entity type:Individual
Prefix:MS
First Name:HILARY
Middle Name:HASTINGS
Last Name:PORTEOUS-NYE
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 1:60 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07505-2003
Mailing Address - Country:US
Mailing Address - Phone:973-754-5597
Mailing Address - Fax:973-754-5599
Practice Address - Street 1:60 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07505-2003
Practice Address - Country:US
Practice Address - Phone:973-754-5597
Practice Address - Fax:973-754-5599
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05254400101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health