Jeffery Haynes, PH.D. LPC,LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH8653 Issued in FL

Practice address

121 Webb Dr Ste 202
Davenport, FL 33837-3904

Phone

(863) 353-9322

Fax

(863) 353-2592

NPI assigned

May 26, 2010

Last updated

Jul 24, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Jeffery Haynes Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jefferyhaynes@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Universal Treatment Services

  • Psychiatric Residential Treatment Facility
  • Duluth, GA
  • NPI 1073252417
  NPD Authorized official
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1245559566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 WEBB DR STE 202",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338373904",
            "telephone_number": "863-353-9322",
            "fax_number": "863-353-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 WEBB DR STE 202",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338373904",
            "telephone_number": "863-353-9322",
            "fax_number": "863-353-2592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "JEFFERY",
        "name_prefix": "Dr.",
        "credential": "PH.D. LPC,LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-26",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH8653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Z04F5",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEFFERY",
            "last_name": "HAYNES",
            "prefix": "DR.",
            "credential": "PHD., LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Andrew J Hanzlik, MD PA
• Upendra Paul Harinarine, PA C
• Anna Michelle Harris, D.O.
• Annette Kay Harris, RN
• Bobbilynn Hawkins, MD
• Ivonne Hazim, RN
• HC Davenport DME, Inc
• Healing and Compassionate Care LLC
• Health Holdings Company LLC (Palm Medical Centers Davenport)
• Heart & Vascular Institute of Florida PLC

• Mental Health Counselor in Davenport, FL
• Providers in Davenport, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.