Active NPI
Roxanne Haynes, LMSW
- Clinical Social Worker
- Clarkston, MI
National Provider Identifier
1104159532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801088453
- Practice address
- 6549 Town Center Dr
Suite a
Clarkston, MI 48346-4824 - Phone
- (248) 620-6400
- Fax
- (248) 620-6405
- NPI assigned
- Sep 17, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801088453 | MI | Primary |
Addresses
Primary practice location
6549 Town Center Dr
Suite a
Clarkston, MI 48346-4824
Mailing address
49061 South Interstate 94
Apt 106
Belleville, MI 48111
Phone (470) 255-7723
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1041C0700X | Medicaid | MI |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364256000000",
"number": "1104159532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49061 SOUTH INTERSTATE 94",
"address_2": "APT 106",
"city": "BELLEVILLE",
"state": "MI",
"postal_code": "48111",
"telephone_number": "470-255-7723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6549 TOWN CENTER DR",
"address_2": "SUITE A",
"city": "CLARKSTON",
"state": "MI",
"postal_code": "483464824",
"telephone_number": "248-620-6400",
"fax_number": "248-620-6405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYNES",
"first_name": "ROXANNE",
"name_prefix": "Mrs.",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-17",
"last_updated": "2013-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801088453",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1041C0700X",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clarkston, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.