Individual provider Active NPI

Tiffany M Haynes, LPC

  • Mental Health Counselor
  • Fairfax, VA
National Provider Identifier
1750859591
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0701012189 Issued in VA
Practice address
3025 Hamaker CT Ste 450
Fairfax, VA 22031-2237
Phone
(240) 800-5772
NPI assigned
Nov 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0701012189 VA Primary
Mental Health Counselor 101YM0800X 16451 FL
Mental Health Counselor 101YM0800X LC12210 MD

Addresses

Primary practice location

3025 Hamaker CT Ste 450
Fairfax, VA 22031-2237

Mailing address

3025 Hamaker CT Ste 450
Fairfax, VA 22031-2237
Phone (240) 800-5772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20250715001638 DC Practitioner - Mental Health Counselor 2668987066 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16451FLMDMental Health Counselor
0701012189VAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Social Service Agency CurrentSince Jul 3, 2025 Accepting new patients
Jewish Social Service Agency CurrentSince Jul 3, 2025 Accepting new patients
Daniel Memorial, Inc. Past Accepting new patients
Daniel Memorial Inc Past Accepting new patients

Locations

6123 Montrose Rd
Rockville, MD 20852
Phone (301) 838-4200

200 Wood Hill Rd
Rockville, MD 20850
Phone (240) 800-5772

3025 Hamaker Ct
Ste 450
Fairfax, VA 22031
Phone (240) 800-5772

Organizations & group practices 4

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": "1541721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1750859591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 HAMAKER CT STE 450",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312237",
            "telephone_number": "240-800-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 HAMAKER CT STE 450",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312237",
            "telephone_number": "240-800-5772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "TIFFANY",
        "middle_name": "M",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-09",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701012189",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "16451",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC12210",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.