Haynie, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

HAYNIE, INC

Practice address

1200 W Apache St
Farmington, NM 87401-3886

Phone

(505) 258-2763

Fax

(505) 675-2803

NPI assigned

Nov 4, 2022

Organization subpart

Yes

Parent organization

HAYNIE, INCAs reported in NPPES

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

Authorized official

Name

Ms. Kimberly Ann Haynie, LCSWNPI 1942758461

Title

Owner

Phone

(505) 258-2763

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• The Phoenix Counseling Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Part of

Haynie Inc

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Ann Haynie, LCSW

  • Clinical Social Worker
  • Farmington, NM
  • NPI 1942758461

  Mental Health

  Medicare reassignment NPD Authorized official
• Melissa Ann Tarazon, LADAC

  • Addiction (Substance Use Disorder) Counselor
  • Farmington, NM
  • NPI 1245574136
  Medicare reassignment NPD

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698796800000",
    "number": "1124735485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W APACHE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874013886",
            "telephone_number": "505-258-2763",
            "fax_number": "505-675-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W APACHE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874013886",
            "telephone_number": "505-258-2763",
            "fax_number": "505-675-2803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAYNIE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HAYNIE, INC",
        "enumeration_date": "2022-11-04",
        "last_updated": "2023-11-01",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "HAYNIE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-258-2763",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32255705",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Phoenix Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert N Hawk, M.A.
• Gregory Scott Hawkins, PHARMD
• Katherine Hawkins, PHARM D
• Nathan Haws
• Mary Hayashi, RPH
• Kimberly Ann Haynie, LCSW
• Abbie J Hazlewood, MS CCC A FAAA
• Mary Catherine Headpowell
• Healthy Lifestyle Education Services
• Hearing Associates Dba Sandia Hearing AIDS

• Community/Behavioral Health Agency in Farmington, NM
• Providers in Farmington, NM by specialty
• Community/Behavioral Health Agency in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.