Individual provider Active NPI

Eric Allan Haynes, LMSW, CAADC

  • Clinical Social Worker
  • Troy, MI
National Provider Identifier
1669001335
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801113623 Issued in MI
Practice address
1639 E Big Beaver Rd Ste 201
Troy, MI 48083-2054
Phone
(248) 528-9000
Fax
(248) 528-9005
NPI assigned
Apr 5, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 680114764 MI
Clinical Social Worker 1041C0700X 6801113623 MI Primary

Addresses

Primary practice location

1639 E Big Beaver Rd Ste 201
Troy, MI 48083-2054

Mailing address

1639 E Big Beaver Rd Ste 201
Troy, MI 48083-2054
Phone (248) 528-9000

Other practice location 1

22255 Greenfield Rd Ste 300
Southfield, MI 48075-3729
Phone (248) 849-3301

Other practice location 2

1454 Strathcona Dr
Detroit, MI 48203-1464
Phone (323) 363-1290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220114000773 MI Practitioner - Clinical Social Worker 4880086263 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Wayne State University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Birgit Amann M D P L L CGroup PAC ID 0749352714, 12 clinicians

Practice addresses (Care Compare)

1639 E Big Beaver Rd
Suite 201
Troy, MI 48083-2054
Phone (248) 528-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801113623MIMDClinical Social Worker
680114764MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Birgit Amann M D P L L C CurrentSince Feb 1, 2023 Accepting new patients
Henry Ford Health Eastwood Behavioral Health CurrentSince Jan 6, 2022 Accepting new patients

Locations

17250 Farmington Rd
Livonia, MI 48152
Phone (734) 425-4070

22255 Greenfield Rd
Ste 300
Southfield, MI 48075
Phone (248) 557-5227

1639 E Big Beaver Rd
Ste 201
Troy, MI 48083
Phone (248) 528-9000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1586044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1669001335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1639 E BIG BEAVER RD STE 201",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480832054",
            "telephone_number": "248-528-9000",
            "fax_number": "248-528-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 E BIG BEAVER RD STE 201",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480832054",
            "telephone_number": "248-528-9000",
            "fax_number": "248-528-9005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22255 Greenfield Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480753729",
            "country_code": "US",
            "telephone_number": "248-849-3301",
            "fax_number": "248-849-5349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1454 Strathcona Dr",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482031464",
            "country_code": "US",
            "telephone_number": "323-363-1290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "ERIC",
        "middle_name": "ALLAN",
        "name_prefix": "Mr.",
        "credential": "LMSW, CAADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-05",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "680114764",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801113623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.