Individual provider Active NPI

Lynn L Haley, PSYD

  • Psychologist
  • Fairfield, OH
National Provider Identifier
1851364871
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6156 Issued in OH
Practice address
3050 Mack Rd
Suite 205
Fairfield, OH 45014-5379
Phone
(513) 682-6980
Fax
(513) 981-5753
NPI assigned
Feb 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6156 OH Primary

Addresses

Primary practice location

3050 Mack Rd
Suite 205
Fairfield, OH 45014-5379

Mailing address

3050 Mack Rd
Suite 205
Fairfield, OH 45014-5379
Phone (513) 682-6980

Other identifiers 1

IdentifierTypeStateIssuer
2647309MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20060404000018 OH Practitioner - Clinical Psychologist 4880602713 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Wright State University Boonshoft School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Cincinnati Specialty Care LLCGroup PAC ID 3971907759, 343 clinicians

Practice addresses (Care Compare)

3050 Mack Rd
Suite 205
Fairfield, OH 45014-5376
Phone (513) 682-6980

8549 Montgomery Rd
Cincinnati, OH 45236-2366
Phone (513) 984-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6156OHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians Cincinnati LLC CurrentSince Jul 1, 2009 Accepting new patients
Lynn L Haley, PSYD, LLC CurrentSince Jul 13, 2013 Accepting new patients
Mercy Health Physicians Cincinnati, LLC CurrentSince Jul 1, 2009 Accepting new patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Charles M. Buhrman, Jr., PSYD, LLC Psychologist Past Accepting new patients

Locations

8549 Montgomery Rd
Cincinnati, OH 45236
Phone (513) 984-3099

2446 Kipling Ave
Cincinnati, OH 45239
Phone (513) 583-8500

3050 Mack Rd
Ste 205
Fairfield, OH 45014
Phone (513) 682-6980

1301 Mattec Dr
Loveland, OH 45140
Phone (513) 454-7246

201 Old Bank Rd
Ste 103
Milford, OH 45150
Phone (513) 248-0100

Organizations & group practices 6

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312416000000",
    "number": "1851364871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 MACK RD",
            "address_2": "SUITE 205",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145379",
            "telephone_number": "513-682-6980",
            "fax_number": "513-981-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 MACK RD",
            "address_2": "SUITE 205",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145379",
            "telephone_number": "513-682-6980",
            "fax_number": "513-981-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "LYNN",
        "middle_name": "L",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2011-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "6156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2647309",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.