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General NPI Number Information
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NPI Number | 1932336054
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Entity Type | Individual
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Provider Name | ANNIE MARIE HAYNES LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 233 N MAIN ST
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City | PORTLAND
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State | AR
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Zip | 71663-9230
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Country | US
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Telephone | 870-737-2221
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Fax | 855-878-5991
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Provider Business Mailing Address
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Address Line | PO BOX 509
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City | DERMOTT
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State | AR
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Zip | 71638-0509
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Country | US
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Telephone | 870-942-3000
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Fax | 870-538-5412
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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 | 7178-C
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License Number State | AR
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