Bradley B Haynes I, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2810 Issued in TN

Practice address

3950 Central Avenue
Memphis, TN 38111

Phone

(901) 458-6291

Fax

(901) 323-4848

NPI assigned

Dec 24, 2007

Last updated

Jan 23, 2008By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Christian Psychological Center, Inc.

  • Psychologist
  • Memphis, TN
  • NPI 1184625006
  NPD (past)

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1336323534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 CENTRAL AVENUE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38111",
            "telephone_number": "901-458-6291",
            "fax_number": "901-323-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 CENTRAL AVENUE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38111",
            "telephone_number": "901-458-6291",
            "fax_number": "901-323-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "BRADLEY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-24",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "2810",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "2810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Radwan Faysal Haykal, MD
• Kenya Haymer
• Queene Haymer
• Alyce Waller Haynes
• Angela Renae Haynes, RDH
• Dariona Haynes
• Derek Haynes
• William Kenneth Haynes III
• Draco Rodregas Hayse, PHARM D
• Erma Hayslett, LMSW

• Clinical Psychologist in Memphis, TN
• Providers in Memphis, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; 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.