Provider Demographics
NPI:1417830365
Name:HASKELL, MANDY
Entity type:Individual
Prefix:
First Name:MANDY
Middle Name:
Last Name:HASKELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2590 ONSLOW DR
Mailing Address - Street 2:MANDYHASKELL4004@GMAIL.COM
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540
Mailing Address - Country:US
Mailing Address - Phone:252-369-7441
Mailing Address - Fax:
Practice Address - Street 1:2590 ONSLOW DR
Practice Address - Street 2:MANDYHASKELL4004@GMAIL.COM
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-2854
Practice Address - Country:US
Practice Address - Phone:252-369-7441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical