Active NPI
Patricia Cockrell Haynes, LCSW
- Clinical Social Worker
- Choctaw, MS
National Provider Identifier
1609531649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C10332
- Practice address
- 210 Hospital Cir
Choctaw, MS 39350-6781 - Phone
- (601) 389-4150
- Fax
- (601) 389-4152
- NPI assigned
- Nov 4, 2021
- Last updated
- Sep 12, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C10332 | MS | Primary |
Addresses
Primary practice location
210 Hospital Cir
Choctaw, MS 39350-6781
Mailing address
210 Hospital Cir
Choctaw, MS 39350-6781
Phone (601) 389-4150
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Patricia.Haynes@choctaw.org | Health Information Exchange (HIE) | |
| CONNECT URL | Patricia.Haynes@choctaw.org | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| C10332 | MS | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1609531649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 HOSPITAL CIR",
"city": "CHOCTAW",
"state": "MS",
"postal_code": "393506781",
"telephone_number": "601-389-4150",
"fax_number": "601-389-4152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 HOSPITAL CIR",
"city": "CHOCTAW",
"state": "MS",
"postal_code": "393506781",
"telephone_number": "601-389-4150",
"fax_number": "601-389-4152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYNES",
"first_name": "PATRICIA",
"middle_name": "COCKRELL",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-04",
"last_updated": "2022-09-12",
"certification_date": "2022-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MS",
"license": "C10332",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Patricia.Haynes@choctaw.org",
"affiliation": "N",
"endpointDescription": "email address",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "210 Hospital Cir",
"city": "Choctaw",
"state": "MS",
"country_code": "US",
"postal_code": "393506781",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Patricia.Haynes@choctaw.org",
"affiliation": "N",
"endpointDescription": "email address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "210 Hospital Cir",
"city": "Choctaw",
"state": "MS",
"country_code": "US",
"postal_code": "393506781",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Choctaw, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.