Jeremy R Hayworth, LPCC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.1700339-SUPV Issued in OH

Practice address

1 Childrens PLZ
Dayton, OH 45404-1815

Phone

(937) 641-3401

Fax

(937) 641-3046

NPI assigned

Sep 22, 2017

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dayton Children's Hospital

  • Child & Adolescent Psychiatry Physician
  • Dayton, OH
  • NPI 1952480030

  Professional

  NPD (past)

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

{
    "created_epoch": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1306355219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933421",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930039",
            "telephone_number": "937-641-5072",
            "fax_number": "937-641-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041815",
            "telephone_number": "937-641-3401",
            "fax_number": "937-641-3046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 N Fairfield Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454322674",
            "country_code": "US",
            "telephone_number": "937-641-5772",
            "fax_number": "937-641-4668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "860 Valley St.",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454042066",
            "country_code": "US",
            "telephone_number": "937-641-3060",
            "fax_number": "937-641-3285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8501 Old Troy Pike",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241054",
            "country_code": "US",
            "telephone_number": "937-641-5772",
            "fax_number": "937-641-4668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 W Tech Blvd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453424865",
            "country_code": "US",
            "telephone_number": "937-641-3401",
            "fax_number": "937-641-3046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYWORTH",
        "first_name": "JEREMY",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-22",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1700339-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0282633",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meta Elizabeth Haynes, NP
• Nicholas Wayne Haynie, DO
• Ali E Hays
• Gabriel Joe Hays, D.O.
• Gerret Hayslip
• Karen Hazlett
• Gerald Allen Hazley
• Carmen Hazlip, LPN
• Shaniqua Carmen Hazlip
• Lucette Anne Hazoume

• Professional Counselor in Dayton, OH
• Providers in Dayton, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2026; 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.