Kimberly Ann Haynie, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-11810 Issued in NM

Practice address

1200 W Apache St
Farmington, NM 87401-3886

Phone

(505) 258-2763

Fax

(505) 675-2803

NPI assigned

Sep 13, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Haynie, Inc

  • Community/Behavioral Health Agency
  • Farmington, NM
  • NPI 1124735485

  Mental Health

  Medicare reassignment NPD Authorized official
• Choices Behavioral Health Services, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Farmington, NM
  • NPI 1134194483
  NPD (past)

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1942758461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W APACHE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874013886",
            "telephone_number": "505-258-2763",
            "fax_number": "505-675-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W APACHE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874013886",
            "telephone_number": "505-258-2763",
            "fax_number": "505-675-2803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "313 W Apache St",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "NM",
            "postal_code": "874015835",
            "country_code": "US",
            "telephone_number": "505-325-5321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYNIE",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-13",
        "last_updated": "2023-11-01",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-11810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61224502",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Scott Hawkins, PHARMD
• Katherine Hawkins, PHARM D
• Nathan Haws
• Mary Hayashi, RPH
• Haynie, Inc
• Abbie J Hazlewood, MS CCC A FAAA
• Mary Catherine Headpowell
• Healthy Lifestyle Education Services
• Hearing Associates Dba Sandia Hearing AIDS
• Hearing Associates Inc.

• Clinical Social Worker in Farmington, NM
• Providers in Farmington, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.