MEDICARE: LASHENA HAYNES 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
1	1041C0700X	Clinical Social Worker	108199	TX
2	1041C0700X	Clinical Social Worker	11964	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508299447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LASHENA HAYNES LCSW

Provider Business Mailing Address
First Line	:	3000 BLACKBURN ST APT 1604
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-2211
Country	:	US
Telephone Number	:	504-758-9280
Fax Number	:

Provider Business Practice Location Address
First Line	:	2496 MARTIN LUTHER KING JR DR APT A
Second Line	:
City	:	ORANGE
State	:	TX
Zip	:	77630-1747
Country	:	US
Telephone Number	:	409-207-9982
Fax Number	:

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

Provider Enumeration Date	:	08/14/2013
Last Update Date	:	02/26/2025

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