Individual provider Active NPI

Martha Haynes

  • Marriage & Family Therapist
  • Elm Grove, WI
National Provider Identifier
1790366540
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2002-124 Issued in WI
Practice address
12425 Knoll Rd Ste 110
Elm Grove, WI 53122-2656
Phone
(262) 292-9991
NPI assigned
Apr 14, 2021
Last updated
Jul 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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 2002-124 WI Primary

Addresses

Primary practice location

12425 Knoll Rd Ste 110
Elm Grove, WI 53122-2656

Mailing address

822 Heather Dr
Elkhorn, WI 53121-1193
Phone (262) 723-1345

Other practice location 1

N8030 Townline Rd
East Troy, WI 53120-3500
Phone (262) 292-9991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2002-124WIMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1790366540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 HEATHER DR",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531211193",
            "telephone_number": "262-723-1345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12425 KNOLL RD STE 110",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222656",
            "telephone_number": "262-292-9991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N8030 Townline Rd",
            "address_purpose": "LOCATION",
            "city": "East Troy",
            "state": "WI",
            "postal_code": "531203500",
            "country_code": "US",
            "telephone_number": "262-292-9991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "MARTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-14",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "2002-124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elm Grove, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; 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.