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General NPI Number Information
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NPI Number | 1013895739
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Entity Type | Individual
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Provider Name | HALEY LYNN MANGO MSW, LCSWA
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Gender | Female
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 5040 NEW CENTRE DR STE D
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City | WILMINGTON
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State | NC
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Zip | 28403-1737
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Country | US
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Telephone | 910-392-4881
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Fax | 910-392-9559
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Provider Business Mailing Address
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Address Line | 1172 KINGSMILL CT
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City | SUNSET BEACH
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State | NC
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Zip | 28468-4480
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Country | US
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Telephone | 631-624-0744
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P021633
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License Number State | NC
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