Clarence A Haynes Jr., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LSW0000000220 Issued in TN

Practice address

1 Veterans Way
Knoxville, TN 37931-3161

Phone

(865) 310-9676

NPI assigned

Sep 28, 2006

Last updated

Feb 26, 2019By 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1497847750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 BEECHWOOD LN",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378307868",
            "telephone_number": "865-310-9676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VETERANS WAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379313161",
            "telephone_number": "865-310-9676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "CLARENCE",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000000220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01127873",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q000599",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet L Haymore, FNP
• Amanda Haynes, BSW
• Amanda Dawn Haynes
• Aneisty Danielle Haynes, RN
• Christy Haynes, FNP
• Jordan Haynes
• Landri Katherine Haynes
• Margo Elizabeth Haynes, BS AND MA
• Brandon Hays, MD
• Shannon K. Hays, PH.D.

• Clinical Social Worker in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; 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.