Individual provider Active NPI

Courtney Kiana Haynes, MH27091

  • Mental Health Counselor
  • Lake Mary, FL
National Provider Identifier
1689356792
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
200 Waymont CT Ste 126
Lake Mary, FL 32746-3413
Phone
(407) 676-1954
NPI assigned
Aug 7, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

200 Waymont CT Ste 126
Lake Mary, FL 32746-3413

Mailing address

3415 W Lake Mary Blvd Unit 950460
Lake Mary, FL 32795-7520
Phone (904) 250-2436

Other practice location 1

310 Waymont Ct Ste 100
Lake Mary, FL 32746-3475
Phone (407) 635-1979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20260519003391 FL Practitioner - Mental Health Counselor 1254800212 Practice locations: Lake Mary, FL

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

188 E Crystal Lake Ave
Unit 138
Lake Mary, FL 32746-3204

310 Waymont CT
Suite 100 Lake Mary Counseling
Lake Mary, FL 32746-3475
Phone (407) 635-1979

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Mary Counseling Mental Health CurrentSince Dec 24, 2023 Accepting new patients
LMC Debary LLC Mental Health PastSince Aug 13, 2023 Accepting new patients

Locations

310 Waymont Ct
Ste 100
Lake Mary, FL 32746
Phone (407) 416-3840

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": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1689356792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 W LAKE MARY BLVD UNIT 950460",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327957520",
            "telephone_number": "904-250-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WAYMONT CT STE 126",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463413",
            "telephone_number": "407-676-1954"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Waymont Ct Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lake Mary",
            "state": "FL",
            "postal_code": "327463475",
            "country_code": "US",
            "telephone_number": "407-635-1979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "COURTNEY",
        "middle_name": "KIANA",
        "credential": "MH27091",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.