Provider Demographics
NPI:1568284024
Name:HAYNES, ASHLEY ALEXA (LMHC)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ALEXA
Last Name:HAYNES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24620 NW 6TH RD
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-0317
Mailing Address - Country:US
Mailing Address - Phone:352-262-1396
Mailing Address - Fax:
Practice Address - Street 1:24620 NW 6TH RD
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:FL
Practice Address - Zip Code:32669-0317
Practice Address - Country:US
Practice Address - Phone:352-262-1396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14709101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor