Individual provider Active NPI

Desiree Haynes, PSYD, MBA

  • Counselor
  • Cincinnati, OH
National Provider Identifier
1073706503
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
11500 Northlake Dr
Suite 230
Cincinnati, OH 45249-1650
Phone
(513) 247-4689
NPI assigned
Aug 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

11500 Northlake Dr
Suite 230
Cincinnati, OH 45249-1650

Mailing address

1504 Patricia Dr Apt B
Yeadon, PA 19050-4050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Business Administration

NPI Registry JSON

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187308800000",
    "number": "1073706503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 PATRICIA DR APT B",
            "city": "YEADON",
            "state": "PA",
            "postal_code": "190504050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 NORTHLAKE DR",
            "address_2": "SUITE 230",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452491650",
            "telephone_number": "513-247-4689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "DESIREE",
        "name_prefix": "Dr.",
        "credential": "PSYD, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-17",
        "last_updated": "2007-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.