Jason R Haynes, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

3754 Lavista Rd Ste 200
Tucker, GA 30084-5627

Phone

(770) 810-5789

NPI assigned

Jan 4, 2020

Last updated

Jan 4, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1578096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578096000000",
    "number": "1710526967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 HIGHLAND LN NE APT 1206",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064338",
            "telephone_number": "404-314-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3754 LAVISTA RD STE 200",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845627",
            "telephone_number": "770-810-5789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "JASON",
        "middle_name": "R",
        "credential": "NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-04",
        "last_updated": "2020-01-04",
        "certification_date": "2020-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Osei Harvey, M.A., LPC, NCC
• Elisabeth Haskins
• Daniel Leroy Hatch, PH.D.
• Hannah Elizabeth Hathorn, M.ED. CCC-SLP
• Jurine D. Hatten, PT
• Mollie Christene Headrick, FNP
• Healing Hands Diagnostic Lab LLC (Healing Hands Diagnostic LLC)
• Healing Outreach Purpose Empowerment
• Health-E LLC (Health-E Medical Center)
• Healthy Minds Psychology Associates Inc

• Mental Health Counselor in Tucker, GA
• Providers in Tucker, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2020; 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.