Active NPI
Jennifer Ann Haynes
- Professional Counselor
- Saint Louis, MO
National Provider Identifier
1134494024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2012007108
- Practice address
- 9962 Lin Ferry Dr
Suite 101
Saint Louis, MO 63123-6961 - Phone
- (314) 843-0043
- Fax
- (314) 843-0201
- NPI assigned
- Mar 12, 2012
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2012007108 | MO | Primary |
Addresses
Primary practice location
9962 Lin Ferry Dr
Suite 101
Saint Louis, MO 63123-6961
Mailing address
9962 Lin Ferry Dr
Suite 101
Saint Louis, MO 63123-6961
Phone (314) 843-0043
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012007108 | MO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emotional Change Inc. | Professional | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331510400000",
"number": "1134494024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9962 LIN FERRY DR",
"address_2": "SUITE 101",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631236961",
"telephone_number": "314-843-0043",
"fax_number": "314-843-0201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9962 LIN FERRY DR",
"address_2": "SUITE 101",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631236961",
"telephone_number": "314-843-0043",
"fax_number": "314-843-0201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYNES",
"first_name": "JENNIFER",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-12",
"last_updated": "2012-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2012007108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.