Individual provider Active NPI

Rachel M Haynes, MHA, LCSW

  • Clinical Social Worker
  • Pensacola, FL
National Provider Identifier
1003042193
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW12352 Issued in FL
Practice address
1221 W Lakeview Ave
Pensacola, FL 32501-1857
Phone
(850) 469-3500
Fax
(850) 595-1400
NPI assigned
Jun 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW12352 FL Primary
Mental Health Counselor 101YM0800X SW12352 FL
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

1221 W Lakeview Ave
Pensacola, FL 32501-1857

Mailing address

1221 W Lakeview Ave
Pensacola, FL 32501-1857
Phone (850) 469-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 1, 2024 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1003042193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 W LAKEVIEW AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011857",
            "telephone_number": "850-469-3500",
            "fax_number": "850-595-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 W LAKEVIEW AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011857",
            "telephone_number": "850-469-3500",
            "fax_number": "850-595-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "RACHEL",
        "middle_name": "M",
        "credential": "MHA, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12352",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW12352",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.