Provider Demographics
NPI:1699117218
Name:HAYNES, MARCIA LOUISE (LPC)
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:LOUISE
Last Name:HAYNES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 COLONIAL HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-5265
Mailing Address - Country:US
Mailing Address - Phone:864-357-0764
Mailing Address - Fax:
Practice Address - Street 1:302 S LIMESTONE ST
Practice Address - Street 2:SUITE 3 AND 5
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29340-3000
Practice Address - Country:US
Practice Address - Phone:864-357-0764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLPC5369101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional