NPIMap

Individual provider Active NPI

Reginald Haynes Jr., LCSW

  • Clinical Social Worker
  • Hampton, VA
National Provider Identifier
1942300694
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904004854 Issued in VA
Practice address
2013 Cunningham Dr
Suite #329
Hampton, VA 23666-3306
Phone
(757) 262-1550
Fax
(757) 262-1544
NPI assigned
Sep 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904004854 VA Primary

Addresses

Primary practice location

2013 Cunningham Dr
Suite #329
Hampton, VA 23666-3306

Mailing address

2013 Cunningham Dr
Suite #329
Hampton, VA 23666-3306
Phone (757) 262-1550

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
0904004854VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Foundations for Change, PC Past Accepting new patients

Organizations & group practices 1

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": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942300694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 CUNNINGHAM DR",
            "address_2": "SUITE #329",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236663306",
            "telephone_number": "757-262-1550",
            "fax_number": "757-262-1544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 CUNNINGHAM DR",
            "address_2": "SUITE #329",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236663306",
            "telephone_number": "757-262-1550",
            "fax_number": "757-262-1544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "REGINALD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904004854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.