Individual provider Active NPI

Andrexiry Haynes

  • Professional Counselor
  • Dallas, TX
National Provider Identifier
1598478778
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
86463 Issued in TX
Practice address
12801 N Central Expy Ste 480-a
Dallas, TX 75243-1716
Phone
(469) 430-9586
NPI assigned
Jan 3, 2023
Last updated
Apr 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Professional Counselor 101YP2500X 86463 TX Primary
Professional Counselor 101YP2500X 86463

Addresses

Primary practice location

12801 N Central Expy Ste 480-a
Dallas, TX 75243-1716

Mailing address

2912 Little Rd
Arlington, TX 76016-1725
Phone (817) 457-6728

Other practice location 1

2912 Little Rd
Arlington, TX 76016-1725
Phone (817) 457-6728

Other practice location 2

14275 Midway Rd Ste 200
Addison, TX 75001-3618
Phone (469) 430-9586

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL simplepractice
CONNECT URL TherapyNotes

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
86463TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Redemptive Hope PLLC Professional CurrentSince Aug 18, 2024 Accepting new patients
Lake Arlington Baptist Church PastSince May 12, 2024 Accepting new patients

Locations

14275 Midway Rd
Addison, TX 75001
Phone (469) 430-8586

14275 Midway Rd
Ste 200
Addison, TX 75001
Phone (214) 420-9301

12801 N Central Expy
Ste 480A
Dallas, TX 75243
Phone (469) 430-9586

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1598478778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2912 LITTLE RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760161725",
            "telephone_number": "817-457-6728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12801 N CENTRAL EXPY STE 480-A",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752431716",
            "telephone_number": "469-430-9586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2912 Little Rd",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760161725",
            "country_code": "US",
            "telephone_number": "817-457-6728",
            "fax_number": "999-999-9999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14275 Midway Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Addison",
            "state": "TX",
            "postal_code": "750013618",
            "country_code": "US",
            "telephone_number": "469-430-9586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "ANDREXIRY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-03",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "86463",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": "86463",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "simplepractice",
            "affiliation": "N",
            "address_1": "2001 W Plano Pkwy Ste 1400",
            "city": "Plano",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750758607",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "TherapyNotes",
            "affiliation": "N",
            "address_1": "2912 Little Rd",
            "city": "Arlington",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760161725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.