Gayron W Haywood, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2011010550 Issued in MO

Practice address

1212 Faraon St Ste 1a
Saint Joseph, MO 64501-2310

Phone

(816) 390-5083

NPI assigned

Apr 26, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1255622148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3106 PICKETT RD",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645031426",
            "telephone_number": "816-390-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 FARAON ST STE 1A",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645012310",
            "telephone_number": "816-390-5083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3106 Pickett Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MO",
            "postal_code": "645031426",
            "country_code": "US",
            "telephone_number": "816-390-5083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYWOOD",
        "first_name": "GAYRON",
        "middle_name": "W",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-26",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2011010550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Saint Joseph, MO
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.