Healthcare Provider Details

I. General information

NPI: 1457354615
Provider Name (Legal Business Name): REGINA BELL HAYNES MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 E MAIN ST SUITE F
LINCOLNTON NC
28092-3356
US

IV. Provider business mailing address

735 SAINT MARKS CHURCH RD
BESSEMER CITY NC
28016-9684
US

V. Phone/Fax

Practice location:
  • Phone: 704-530-8048
  • Fax: 704-435-9784
Mailing address:
  • Phone: 704-530-8048
  • Fax: 704-435-9784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC003947
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: