MEDICARE: REBECCA HAYNES

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
1	225C00000X	Rehabilitation Counselor
2	101Y00000X	Counselor
3	101YP2500X	Professional Counselor	91976	TX

General Provider Information

NPI Number	:	1164203048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA HAYNES

Provider Business Mailing Address
First Line	:	1600 GOLDENROD LN
Second Line	:
City	:	KELLER
State	:	TX
Zip	:	76248-9764
Country	:	US
Telephone Number	:	405-588-9060
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 GOLDENROD LN
Second Line	:
City	:	KELLER
State	:	TX
Zip	:	76248-9764
Country	:	US
Telephone Number	:	405-588-9060
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2023
Last Update Date	:	05/15/2026

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Directions to “ REBECCA HAYNES ” Practice Location

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