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NPI Code Detail

MEDICARE: JOAN (JONI) C HAYNES ACSW, LCSW

MEDICARE:   JOAN (JONI) C HAYNES  ACSW, LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCSW001460GA

General Provider Information

NPI Number : 1992758072
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOAN (JONI) C HAYNES ACSW, LCSW
Provider Business Mailing Address
First Line : 9998 FORD AVE., SUITE 5
Second Line :
City : RICHMOND HILL
State : GA
Zip : 31324-4062
Country : US
Telephone Number : 912-756-7136
Fax Number : 913-756-7146
Provider Business Practice Location Address
First Line : 9998 FORD AVE STE 5
Second Line :
City : RICHMOND HILL
State : GA
Zip : 31324-4062
Country : US
Telephone Number : 912-756-7136
Fax Number : 913-756-7146
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2006
Last Update Date : 08/15/2013

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