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General NPI Number Information
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NPI Number | 1740995075
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Entity Type | Individual
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Provider Name | DEANA SUZANNE WOODRUFF HAYNES LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/20/2023
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 1060 PELICAN BAY DR
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City | DAYTONA BEACH
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State | FL
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Zip | 32119-9700
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Country | US
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Telephone | 386-868-1992
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Fax |
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Provider Business Mailing Address
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Address Line | 608 ASHEVILLE SPRINGS CIR
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City | ASHEVILLE
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State | NC
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Zip | 28806-8899
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Country | US
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Telephone | 386-846-2522
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW25305
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License Number State | FL
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