Individual provider Active NPI

Kerricia Peta Gaye Haynes

  • Mental Health Counselor
  • Killeen, TX
National Provider Identifier
1861301145
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
103716 Issued in TX
Practice address
2303 Timberline Dr
Killeen, TX 76543-5749
Phone
(347) 376-2920
NPI assigned
Sep 3, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 103716 TX Primary

Addresses

Primary practice location

2303 Timberline Dr
Killeen, TX 76543-5749

Mailing address

2303 Timberline Dr
Killeen, TX 76543-5749
Phone (347) 376-2920

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1788393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1861301145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2303 TIMBERLINE DR",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765435749",
            "telephone_number": "347-376-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2303 TIMBERLINE DR",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765435749",
            "telephone_number": "347-376-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "KERRICIA",
        "middle_name": "PETA GAYE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-03",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "103716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.