Healthcare Provider Details

I. General information

NPI: 1003284977
Provider Name (Legal Business Name): HALEY STANSBERRY WENTWORTH LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2015
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 LOWELL ST
WILMINGTON MA
01887-3091
US

IV. Provider business mailing address

226 LOWELL ST
WILMINGTON MA
01887-3091
US

V. Phone/Fax

Practice location:
  • Phone: 978-775-2516
  • Fax:
Mailing address:
  • Phone: 978-775-2516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10004365
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: