Elwanda Haynes, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34007916A Issued in IN

Practice address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Phone

(317) 621-7561

NPI assigned

Sep 5, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1473033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507507200000",
    "number": "1770030066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11531 CONGRESSIONAL LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462359700",
            "telephone_number": "317-413-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-621-7561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "ELWANDA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-05",
        "last_updated": "2017-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33007273A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007916A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Ross Hayford, M.D.
• Neal Hayhurst
• Haymaijo Inc
• Shawn Haymaker, LMHC, ATR
• Addison Haynes, RBT
• Jakob Haynes
• Kathleen Blanton Haynes, PHARM.D.
• Kenton James Haynes
• Latoya Haynes
• Paul Kendel Haynes, M.D.

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; 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.