Individual provider Active NPI

Michael E Haynes Jr., LMFT

  • Marriage & Family Therapist
  • Sacramento, CA
National Provider Identifier
1730514431
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
94657 Issued in CA
Practice address
4600 Broadway
Sacramento, CA 95820-1527
Phone
(279) 842-0562
NPI assigned
Sep 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 94657 CA Primary

Addresses

Primary practice location

4600 Broadway
Sacramento, CA 95820-1527

Mailing address

1015 Riley St Unit 223
Folsom, CA 95763-4010
Phone (916) 472-0364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 15, 2024 through Apr 15, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
94657CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Whole Wellness Therapy, a Licensed Clinical Social Worker Corporation CurrentSince Jun 4, 2023 Accepting new patients

Locations

4112 Pennsylvania Ave
Fair Oaks, CA 95628
Phone (916) 619-7744

Organizations & group practices 1

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": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1730514431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 RILEY ST UNIT 223",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "957634010",
            "telephone_number": "916-472-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 BROADWAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958201527",
            "telephone_number": "279-842-0562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-12",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "94657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.