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NPI Code Detail

MEDICARE: MRS. JAIMY HASKINS LCSW

MEDICARE: MRS. JAIMY HASKINS 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
1104100000XSocial Worker33009637AIN
21041C0700XClinical Social Worker34009862AIN

General Provider Information

NPI Number : 1013672096
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JAIMY HASKINS LCSW
Provider Business Mailing Address
First Line : 7550 S MERIDIAN ST STE A
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46217-2912
Country : US
Telephone Number : 317-992-1919
Fax Number :
Provider Business Practice Location Address
First Line : 7550 S MERIDIAN ST STE A
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46217-2912
Country : US
Telephone Number : 317-992-1919
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2021
Last Update Date : 02/16/2023

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