Healthcare Provider Details

I. General information

NPI: 1659298099
Provider Name (Legal Business Name): KACIE HAYNES NCC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7278 CAHABA VALLEY RD APT 404B
BIRMINGHAM AL
35242-8401
US

IV. Provider business mailing address

7278 CAHABA VALLEY RD APT 404B
BIRMINGHAM AL
35242-8401
US

V. Phone/Fax

Practice location:
  • Phone: 334-782-9170
  • Fax:
Mailing address:
  • Phone: 334-782-9170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC06032
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: