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NPI Code Detail

MEDICARE: MIA HAYNES

MEDICARE: MIA 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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1184575698
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIA HAYNES
Provider Business Mailing Address
First Line : 1328 W 70TH ST REAR HOUSE
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-2020
Country : US
Telephone Number : 440-255-1700
Fax Number :
Provider Business Practice Location Address
First Line : 9220 MENTOR AVE
Second Line :
City : MENTOR
State : OH
Zip : 44060-6412
Country : US
Telephone Number : 440-255-1700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2026
Last Update Date : 02/09/2026

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Directions to “ MIA HAYNES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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