Individual provider Active NPI

Karlene S Haines, LCSW-C

  • Clinical Social Worker
  • Severna Park, MD
National Provider Identifier
1245254812
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13174 Issued in MD
Practice address
645 Baltimore Annapolis Blvd
Suite 107
Severna Park, MD 21146-3931
Phone
(443) 481-9028
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 13174 MD Primary

Addresses

Primary practice location

645 Baltimore Annapolis Blvd
Suite 107
Severna Park, MD 21146-3931

Mailing address

645 Baltimore Annapolis Blvd
Suite 107
Severna Park, MD 21146-3931
Phone (443) 481-9028

Other identifiers 1

IdentifierTypeStateIssuer
411174500MedicaidMD

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
13174MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1245254812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 BALTIMORE ANNAPOLIS BLVD",
            "address_2": "SUITE 107",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463931",
            "telephone_number": "443-481-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 BALTIMORE ANNAPOLIS BLVD",
            "address_2": "SUITE 107",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463931",
            "telephone_number": "443-481-9028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAINES",
        "first_name": "KARLENE",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "411174500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.