Provider Demographics
NPI:1487296182
Name:HAYNES, SANDRA K (LPC CANDIDATE)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:K
Last Name:HAYNES
Suffix:
Gender:F
Credentials:LPC CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 721214
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73172-1214
Mailing Address - Country:US
Mailing Address - Phone:580-484-1988
Mailing Address - Fax:
Practice Address - Street 1:3140 W BRITTON RD STE 201
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-2039
Practice Address - Country:US
Practice Address - Phone:405-607-6292
Practice Address - Fax:405-607-6307
Is Sole Proprietor?:No
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health